D-二聚体水平变化与类风湿关节炎合并间质性肺病的相关性研究

Correlation between D-dimer level changes and rheumatoid arthritis complicated with interstitial lung disease

目的分析D-二聚体(D-Dimer,D-D)水平变化与类风湿关节炎合并间质性肺病(rheumatoid arthritis interstitial lung disease,RA-ILD)的相关性,探讨D-D对RA-ILD病情判断的临床价值。方法根据是否合并间质性肺病(ILD),将83例类风湿关节炎(RA)患者分为观察组(合并ILD,40例)和对照组(单纯RA,43例)。收集患者的临床资料,比较2组患者入院时和出院前的D-D水平,采用Pearson相关分析D-D与各临床资料的相关性。结果观察组年龄、吸烟者占比、病程、DAS 28评分、HRCT评分,以及ESR、RF水平均高于对照组,肺功能指标水平低于对照组,差异均有统计学意义(P<0.05)。入院时,观察组D-D水平高于对照组,差异有统计学意义(t=3.524,P=0.001);出院前1天,2组患者的D-D水平差异无统计学意义(t=0.923,P=0.359),观察组D-D水平低于入院时,差异有统计学意义(P<0.05)。Pearson相关分析显示,RA-ILD患者的D-D水平与DAS 28、HRCT评分呈高度正相关,与肺功能各项指标水平呈高度负相关,均P<0.05。结论与单纯RA患者相比,RA-ILD患者的D-D水平明显升高,检测D-D水平对判断RA患者是否合并ILD有一定临床价值。

Objective To investigate the correlation between D-Dimer(D-D)levels and rheumatoid arthritis interstitial lung disease(RA-ILD),as well as to explore the clinical utility of D-D in diagnosing RA-ILD.Methods According to the diagnosis of interstitial lung disease(ILD),83 patients with rheumatoid arthritis(RA)were categorized into an observation group(40 cases with ILD)and a control group(43 cases with RA alone).Patient clinical data were collected,and D-D levels were compared between the two groups upon admission and prior to discharge.Pearson correlation analysis was utilized to examine the relationship between D-D levels and clinical data.Results Age,percentage of smokers,course of the disease,DAS 28 score,HRCT score,ESR,and RF levels in the observation group were higher than those in the control group,while lung function index levels in the observation group were lower than those in the control group,with statistical significance(P<0.05).Upon admission,the observation group exhibited a statistically significant elevation in D-D levels compared to the control group(t=3.524,P=0.001).However,one day prior to discharge,there was no discernible difference in D-D levels between the two groups(t=0.923,P=0.359),although the observation group demonstrated a significant decrease in D-D levels from admission(P<0.05).The Pearson correlation analysis revealed a significant positive association between D-D levels and both DAS 28 scores and HRCT scores in RA-ILD patients,while a significant negative correlation was observed between D-D levels and lung function indexes(all P<0.05).Conclusions Compared to RA patients without ILD,those with RA-ILD exhibit a significant increase in D-D levels,indicating that detecting D-D levels can be clinically valuable in identifying the presence of ILD in RA patients.