78例类风湿关节炎胸腔积液临床特点分析

目的 探讨类风湿关节炎胸腔积液的特点,提高对该病的认识。方法 回顾分析类风湿关节炎胸腔积液的特点。结果 类风湿关节炎缓解状态下无胸腔积液出现,胸腔积液发生在疾病活动期,且集中在疾病中度、高度活动期,两组低、中、高度患者构成比差异具有统计学意义(P＜0.05)。有胸腔积液组平均血沉(erthrocyte sedimentation rate,ESR)、C反应蛋白(C-reactive protein,CRP)较无胸腔积液组高,类风湿因子(rheumatoid factor,RF)、抗环瓜氨酸肽抗体(anti-cyclic citrullinated peptide antibaody,抗CCP抗体)阳性率较无胸腔积液组高(P＜0.05)。有胸腔积液组平均压痛关节数、平均肿胀关节数较无胸腔积液组多,平均晨僵时间较无胸腔积液组长(P＜0.05)。有胸腔积液组病情缓解数较无胸腔积液组少,有新增关节变形个数较无胸腔积液组多(P＜0.05)。结论 类风湿关节炎患者出现胸腔积液是病情活动的标志,与免疫指标,临床症状呈正相关,临床应进行强有力的治疗。

Clinical feature of pleural effusion in 78 patients with rheumatoid arthritis

Objective To investigate the feature of pleural effusion in patients with rheumatoid arthritis for the recognition of the disease.Methods The clinical feature of pleural effusion in patients with rheumatoid arthritis was retrospectively analyzed.Results There was no pleural effusion in patients with remission of rheumatoid arthritis, all patients with pleural effusion were in active phase of the disease, especially in moderate and high active phase, significant difference in the number of patients was detected in low, moderate and high active phases of rheumatoid arthritis between groups (P＜0.05). The average levels of erythrocyte sedimentation rate and C-reactive protein were significantly higher in pleural effusion group than in non-pleural effusion group. The positive rates of rheumatoid factor and anti-cyclic citrullinated peptide antibody were significantly higher in pleural effusion group than in non-pleural effusion group (P＜0.05). The average number of joint tenderness and swollen joint was significantly higher in pleural effusion group than in non-pleural effusion group and the average time of morning stiffness was significantly longer in pleural effusion group than in non-pleural effusion group (P＜0.05). Compared with non-pleural effusion group, the remission number of patients was significantly decreased in pleural effusion group (P＜0.05), and the number of new joint deformity was significantly increased in pleural effusion group (P＜0.05).Conclusion Rheumatoid arthritis patients present pleural effusion as an active signal of disease, which was positively correlated with immune index and clinical symptom and should get rigorously treated.