类风湿关节炎合并肺间质病变危险因素分析

发布时间：2018-03-28 21:47

本文选题：关节炎　切入点：类风湿　出处：《重庆医学》2017年23期

【摘要】：目的通过对类风湿关节炎相关肺间质病变(RA-ILD)患者胸部CT影像学资料进行分析,探讨RA-ILD患者相关肺部病变的特点,分析RA-ILD的危险因素,为RA-ILD诊断、治疗、预后提供参考。方法总结323例类风湿关节炎(RA)患者CT表现,共发现RA-ILD患者75例,以75例RA-ILD患者为病例组,排除ILD后余248例为对照组。对两组一般情况、实验室检查、CT结果等进行对比分析。结果 ILD分型:特发性肺纤维化(IPF)43例(57.3%),其次特发性非特异性间质性肺炎(NSIP)11例(14.7%)。Logistic单因素分析结果显示从ILD的构成看,有吸烟史的患者中33.3%有ILD,高于无吸烟史的患者;RF值越高,抗CCP值越高,有ILD的比例越高;Logistic多因素结果显示RF值大于200U/mL(OR=3.236,95%CI:1.271~8.240,P=0.014)是RA-ILD的独立预测因素。结论临床上吸烟、高水平RF及抗CCP的RA患者应及时筛查ILD,CT尤其高分辨CT检查有助于早期诊断肺间质病变。
[Abstract]:Objective to analyze the chest CT imaging data of patients with rheumatoid arthritis associated with pulmonary interstitial lesion (RA-ILD), to explore the characteristics of pulmonary lesions associated with RA-ILD, and to analyze the risk factors of RA-ILD for diagnosis and treatment of RA-ILD. Methods CT findings of 323 patients with rheumatoid arthritis (RA) were summarized. 75 patients with RA-ILD were found, 75 patients with RA-ILD as case group and 248 patients as control group after excluding ILD. Results according to ILD classification, 43 cases of idiopathic pulmonary fibrosis (IPF) were found to be 57.3%, followed by 11 cases of idiopathic nonspecific interstitial pneumonia. Logistic univariate analysis showed that the composition of IPF was based on the composition of ILD. 33. 3% of the patients with smoking history had ILD. The higher the RF value, the higher the anti CCP value, the higher the ratio of anti CCP, the higher the proportion of ILD. The results showed that the RF value was greater than 200 UmLOR3.23695% CI: 1.271% 8.240% P0.014) was an independent predictor of RA-ILD. Conclusion smoking in clinic is an independent predictor of RA-ILD. High level RF and anti-CCP RA patients should be screened in time, especially high resolution CT scan is helpful for early diagnosis of pulmonary interstitial lesions.
【作者单位】：广东省中山市人民医院风湿免疫科;中山大学附属第三医院风湿科;
【分类号】：R563;R593.22

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