探讨老年类风湿关节炎合并间质性肺疾病的临床特点

Discussion on the clinical characteristics of elderly rheumatoid arthritis complicated with interstitial lung disease

目的分析老年类风湿关节炎合并间质性肺疾病的临床特点。方法选取30例老年类风湿关节炎患者作为研究对象,其中12例患者合并间质性肺疾病(A组),18例患者未合并间质性肺疾病(B组)。比较两组患者的一般资料、类风湿因子滴度及肺功能指标水平。结果A组患者的病程(5.7±1.6)年长于B组的(2.3±0.3)年,差异具有统计学意义(P<0.05);两组患者的性别、年龄、晨僵时间比较,差异无统计学意义(P>0.05)。A组患者的类风湿因子滴度(172.4±28.5)U/ml高于B组的(95.5±16.7)U/ml,一氧化碳弥散量(97.5±6.3)ml/(min·kPa)低于B组的(112.3±4.9)ml/(min·kPa),差异均具有统计学意义(P<0.05);两组患者的用力肺活量、第1秒用力呼气容积比较,差异均无统计学意义(P>0.05)。结论老年类风湿关节炎患者病程越长、类风湿因子滴度越高时极易合并间质性肺疾病,一氧化碳弥散量的检测对其是否合并间质性肺疾病具有临床诊断价值。

Objective To analyze the clinical characteristics of elderly rheumatoid arthritis complicated with interstitial lung disease.Methods A total of 30 elderly patients with rheumatoid arthritis(RA)were selected as the study subjects.12 patients were complicated with interstitial lung disease(group A)and 18 patients were not complicated with interstitial lung disease(group B).The clinical data,rheumatoid factor titer and pulmonary function index level between the two groups were compared.Results The course of disease was(5.7±1.6)years in group A,and that was longer than(2.3±0.3)years in group B.The difference was statistically significant(P<0.05).There was no statistically significant difference in gender,age,duration of morning stiffness between the two groups(P>0.05).The rheumatoid factor titer(172.4±28.5)U/ml in group A was higher than(95.5±16.7)U/ml in group B,and diffusion capacity for carbon monoxide(97.5±6.3)ml/(min·kPa)was lower than(112.3±4.9)ml/(min·kPa)in group B.Their difference was statistically significant(P<0.05).There was no statistically significant difference in forced vital capacity,forced expiratory volume in the 1st second between the two groups(P>0.05).Conclusion The longer the course of rheumatoid arthritis and the higher the rheumatoid factor titer,the more likely the elderly patients are to be complicated with interstitial lung disease.The detection of diffusion capacity for carbon monoxide has clinical diagnostic value for the elderly patients with rheumatoid arthritis complicated with interstitial lung disease.