类风湿关节炎合并肺间质病变的临床特点

目的 分析类风湿关节炎（RA）合并肺间质纤维化（ILD）患者的临床特点,为尽早发现和诊断RA-ILD提供有价值的临床信息.方法 回顾性分析2008年1月～2009年1月于我院就诊的40例RA-ILD患者与42例未合并ILD的RA患者的临床资料,并对两组患者的临床资料加以比较.结果 RA-ILD组患者多数以咳嗽为首发症状,全部患者高分辨率CT检查均存在不同程度的ILD表现.RA-ILD组患者的病程、晨僵时间长于未合并ILD的RA组患者（P＜0.05）.RA-ILD患者组的DAS28评分、血沉、C反应蛋白、抗环瓜氨酸（CCP）抗体、Ro-52阳性率高于未合并ILD的RA组患者（P均＜0.05）.结论 RA-ILD患者多数以咳嗽为首发症状,高分辨率CT能较早的提示ILD并评价其严重程度.RA病程、活动性、炎性指标、抗CCP抗体及抗Ro-52可能是与RA-ILD密切相关的重要指标.

Characteristics of rheumatoid arthritis with secondary interstitial lung disease

Objective To analyze the clinical characteristics of interstitial lung disease, （ILD）in patients with Rheumatoid arthritis （RA）. Methods We retrospectively analyzed 82 RA patients with or without ILD. Characteristics of RA-ILD in clinical and lab data were analyzed. Clinical and lab data were compared between the patients with and without ILD. Results Most first symptoms of RA-ILD patients show cough. 100% RA-ILD patients had HRCT findings. RA-ILD patients had longer disease duration, morning stiffness time than those without ILD （ P 〈 0. 05 ） ; Higher ESR, CRP, anti-CCP, Higher DAS28 scoring and anti-Ro-52 antibody were found in RA-ILD compared to patients without ILD （ P 〈 0.05 ）. Conclusion Most first symptoms of lung in RA-ILD patients show cough. HRCT could prompt early ILD and evaluate serious level. Hypoxemia and ventilatory functional disturbance were rare. The duration and activity of RA, anti-CCP, anti-Ro-52 might be important factors associated with RA-ILD.