类风湿性关节炎并发肺间质纤维化23例临床分析

目的探讨类风湿性关节炎（RA）并发肺间质纤维化的发生情况、临床特点、肺功能、影像学检查及相关因素。方法分析我院146例住院RA患者的临床资料，包括类风湿性因子（RF）、血气分析、胸部x线、肺高分辨CT（HRCT）、肺功能检查等，分析RA并发肺间质纤维化患者的特点。结果本组RA患者中并发肺间质纤维化23例；其中，RF强阳性17例，ESR增高21例，CRP增高18例，血小板增高14例，低氧血症17例，经过适当的治疗，病情一般能够控制，有2例死亡，占8．7％，死亡原因为I型呼吸衰竭。结论患者呼吸系统病患出现在关节炎之后，肺间质纤维化的发生与重症类风湿关节炎有关，但病情较轻，RA患者应尽早做肺HRCT及肺功能检查，尤其是RF强阳性的RA患者。

Clinical analysis of 23 cases of interstitial pulmonary fibrosis in rheumatoid arthritis

Objective To observe the occurrence, clinical characteristics, pulmonary function,radiographic finding and the associated factors of pulmonary interstitial fibrosis in rheumatoid arthritis （RA） in order to build up knowledge base for early diagnosis. Methods The clinical data of 146 admitted RA patients analyzed retrospectively including rheumatoid factor （RF）, blood-gas analysis, chest X- ray, chest HRCT, and pulmonary function tests. Results 23 RA patients concurred with interstitial pulmonary fibrosis （IPF）. Among the 23 RA patients with IPF,17 cases were with strongly positive RF,21 cases with elevated ESR,18 cases with elevated CRP,14 cases with elevated platelets account and 17 cases with hypoxemia. When treated appropriately,IPF secondary to RA could be well controlled. Only 2 deaths occurred in this study and the mortality was 8.7%. The cause of the death was type respiratory failure. Conclusion Respiratory symptoms are presented after the joint symptoms. IPF is related to the severity of RA. HRCT and pulmonary function test should be taken early in order to get early diagnosis and treatment, especially in those with strongly positive RF.