抗环瓜氨酸肽抗体与类风湿关节炎合并肺间质病变的相关性研究

发布时间：2018-06-14 00:51

  本文选题：类风湿关节炎 + 肺间质病变　； 参考：《重庆医科大学》2017年硕士论文

【摘要】：目的:探讨抗环瓜氨酸肽抗体(抗CCP抗体)与类风湿关节炎合并肺间质病变(RA-ILD)的相关性。方法:选取重庆医科大学附属第一医院中西医结合科2013年5月—2016年2月住院收治的241例RA患者临床资料,其中男性55例,女性186例,平均年龄56岁。依据胸部X片和(或)高分辨率CT检查结果分为两组:合并肺间质病变组(RA-ILD组)65例(26.97%),单纯RA组176例(73.03%)。通过t检验及χ~2检验进行单因素分析,将有意义的变量纳入多因素Logistic回归分析。结果:单因素分析表明,抗CCP抗体滴度(226.46±132.20 vs148.51±73.96 u/ml,t值=-2.81,P=0.005)、年龄(63.26±12.11 vs53.47±13.56/岁,t值=-5.39,P=0.000)、吸烟史(20%vs13.07%,χ~2值=6.92,P=0.009)、受累关节数(13.4±5.04 vs 11.6±5.61/个,t值=-2.34,P=0.021)、病程长短(105.22±104.19 vs 69.71±94.13/月,t值=-2.52,P=0.012)对RA合并ILD有统计学意义(P0.05)。两组患者性别分布、血沉(ESR)、类风湿因子(RF)、C-反应蛋白(CRP)、血小板(PLT)、C3、C4、Ig A、Ig G差异无统计学意义(P0.05)。多因素分析结果表明,抗CCP抗体(χ~2=4.509,OR=1.002,P值=0.034)、年龄(χ~2=16.203,OR=1.058,P值=0.000)是RA患者合并ILD的独立危险因素。分层检验提示RA-ILD组抗CCP抗体高滴度(≥300 u/ml)患者所占的百分比明显高于单纯RA组(35.38%vs 20.44%,P=0.017)。结论:年龄、抗CCP抗体可能与RA患者合并肺间质病变密切相关,故对高龄、高滴度抗CCP抗体的RA患者应早期行HRCT检查,以早期诊断和治疗。
[Abstract]:Objective: to investigate the correlation between anti-cyclic citrullin-peptide antibody (anti-CCP) and RA- ILD in rheumatoid arthritis complicated with pulmonary interstitial disease. Methods: 241 RA patients, 55 males and 186 females, with an average age of 56 years, were selected from the Department of Integrated Chinese Medicine and Western Medicine of the first affiliated Hospital of Chongqing Medical University from May 2013 to February 2016. According to the results of chest X ray and / or high resolution CT, the patients were divided into two groups: 65 patients with RA-ILD complicated with pulmonary interstitial disease and 176 patients with RA. Through t test and 蠂 2 test univariate analysis was carried out, and the significant variables were included in multivariate logistic regression analysis. 缁撴灉:鍗曞洜绱犲垎鏋愯〃鏄，

本文编号：2016291