类风湿关节炎继发不同类型肺间质病变临床分析
发布时间：2018-08-09 16:08
【摘要】：目的比较类风湿关节炎(RA)继发不同类型肺间质病变(ILD)患者的临床、肺部影像以及肺功能特点。方法选择2007年1月至2013年4月北京大学第一医院风湿免疫科或呼吸科住院经高分辨CT(HRCT)确诊、资料完整的RA-ILD的患者51例,收集临床、血气分析、RA血清学及肺功能等指标,比较不同肺HRCT分类患者临床特点的差异。结果肺HRCT下寻常型间质性肺炎(UIP)改变13例,非特异性间质性肺炎(NSIP)改变10例,机化性肺炎(OP)改变8例,无法分类20例,各组在性别、年龄、吸烟史、血清学指标方面差异无统计学意义;12例患者在确诊RA前出现ILD,其余39例患者ILD出现在RA诊断后或与RA同时出现,RA诊断后继发NSIP的中位时间间隔为1.45年(IQR 4.37,范围0~9.75年),早于其他类型ILD患者(P0.05),OP患者的Pa O2[(7.65±1.38)k Pa]低于其他类型ILD患者[UIP(10.23±1.58)mm Hg,NSIP(9.56±3.05)mm Hg,无法分类(10.41±2.39)mm Hg,P0.05]。不同类型ILD患者的肺功能水平比较差异无统计学意义。Logistic回归分析发现,ILD病程(OR=1.451,95%CI1.032~2.040,P=0.032)、NSIP(OR=8.326,95%CI 1.243~55.778,P=0.029)以及OP(OR=17.431,95%CI 1.901~159.811,P=0.011)是RA-ILD出现Ⅰ型呼吸衰竭的独立危险因素。结论 UIP是RA-ILD患者经肺HRCT可以明确分型间质病中最常见的类型,部分患者在RA发病后短期内出现ILD、NSIP、OP以及ILD病程是出现Ⅰ型呼吸衰竭的危险因素,因此,RA患者应积极筛查ILD。
[Abstract]:Objective to compare the clinical features, pulmonary imaging and pulmonary function of (ILD) patients with rheumatoid arthritis (RA) secondary to different types of pulmonary interstitial lesions. Methods from January 2007 to April 2013, 51 patients with RA-ILD diagnosed by high resolution CT (HRCT) were selected from Rheumatological Immunology Department or Respiratory Department, first Hospital of Peking University. Clinical data were collected, serum gas was analyzed for RA serology and pulmonary function. To compare the clinical characteristics of different lung HRCT classification patients. Results there were 13 cases of (UIP) changes of interstitial pneumonia vulgaris, 10 cases of (NSIP) change of nonspecific interstitial pneumonia, 8 cases of (OP) change of organic pneumonia and 20 cases of no classification under pulmonary HRCT. There was no significant difference in serological parameters between 12 patients with ILD before the diagnosis of RA. The median interval of NSIP after diagnosis of RA or with RA was 1.45 years (IQR 4.37, range 0, 9.75). Pao _ 2 [(7.65 卤1.38) k Pa)] was earlier than that in other types of ILD patients (P0.05) and lower than that in other types of ILD patients [UIP (10.23 卤1.58) mm HgN NSIP (9.56 卤3.05) mm Hg,) could not be classified into (10.41 卤2.39) mm HgP (P0.05)]. Logistic regression analysis showed that the course of ILD (ORL 1.45195 CI 1.03222.040 P0. 032) and op (OR17.4331 95 CI 1.901 159.811P0.011) were independent risk factors of type 鈪，
本文编号：2174623
[Abstract]:Objective to compare the clinical features, pulmonary imaging and pulmonary function of (ILD) patients with rheumatoid arthritis (RA) secondary to different types of pulmonary interstitial lesions. Methods from January 2007 to April 2013, 51 patients with RA-ILD diagnosed by high resolution CT (HRCT) were selected from Rheumatological Immunology Department or Respiratory Department, first Hospital of Peking University. Clinical data were collected, serum gas was analyzed for RA serology and pulmonary function. To compare the clinical characteristics of different lung HRCT classification patients. Results there were 13 cases of (UIP) changes of interstitial pneumonia vulgaris, 10 cases of (NSIP) change of nonspecific interstitial pneumonia, 8 cases of (OP) change of organic pneumonia and 20 cases of no classification under pulmonary HRCT. There was no significant difference in serological parameters between 12 patients with ILD before the diagnosis of RA. The median interval of NSIP after diagnosis of RA or with RA was 1.45 years (IQR 4.37, range 0, 9.75). Pao _ 2 [(7.65 卤1.38) k Pa)] was earlier than that in other types of ILD patients (P0.05) and lower than that in other types of ILD patients [UIP (10.23 卤1.58) mm HgN NSIP (9.56 卤3.05) mm Hg,) could not be classified into (10.41 卤2.39) mm HgP (P0.05)]. Logistic regression analysis showed that the course of ILD (ORL 1.45195 CI 1.03222.040 P0. 032) and op (OR17.4331 95 CI 1.901 159.811P0.011) were independent risk factors of type 鈪，
本文编号：2174623
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