类风湿关节炎合并肺间质病变的临床特点及相关因素

目的分析类风湿关节炎合并肺间质病变(RA-ILD)患者的临床特点及相关因素。方法回顾性分析2006年9月-2011年5月我院住院及门诊病人93例RA-ILD及93例未合并ILD的类风湿关节炎(RA)患者的一般情况、临床特点及类风湿因子(RF)、血沉(ESR)、C反应蛋白(CRP)、抗核抗体(ANA)及抗角蛋白抗体(AKA)、抗环瓜氨酸肽(CCP)抗体、抗SSA/SSB抗体、红细胞计数(RBC)、血红蛋白(HGB)、血小板计数(PLT)进行比较。结果 RA-ILD组患者呼吸系统症状多数以咳嗽为首发症状。RA-ILD组患者年龄、RF滴度、吸烟构成比均显著高于无ILD的RA组,有统计学意义(P均<0.05)。RA-ILD组病程、性别、ESR、CRP、ANA、抗SSA/SSB抗体,以及服用甲氨蝶呤与无ILD的RA组比较差异无统计学意义(P均>0.05)。经过后退法建立Logistic回归分析模型,多因素分析显示年龄(OR=1.093,95%CI 1.053～1.136,P<0.05),年龄每增大1岁,危险性增加0.093倍。结论年龄增大是RA发生ILD的相关因素,高龄的RA患者应警惕ILD的发生。

Clinical Features and Risk Factors in Patients with Rheumatoid Arthritis Combined with Interstitial Lung Disease

Objective To analyze the clinical features and risk factors of rheumatoid arthritis combined with interstitial lung disease(RA-ILD).Methods 93 cases with RA-ILDand 93 cases with RA without ILD from September,2006 to May,2011 were retrospectively analyzed.General,Clinical,rheumatoid factor(RF),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),antinuclear antibody(ANA),anti-keratin antibody(AKA),anti-cyclic citrullinated peptide antibody(CCP),anti-SSA/anti-SSB,red blood cell(ESR),hemoglobin(HGB) and platelets(PLT) were compared between two groups.Results First symptoms of RA-ILD patients was cough.The age,RF level,prevalences of smoking in RA-ILD group were significantly higher than those in control group(P<0.05).The disease courses,sex,ESR,CRP,ANA,SSB,SSA and the therapeutic effect of methotrexate(MTX) had not significant difference between two groups(P>0.05).The Logistic regression model showed that onset age were significantly associated with pulmonary disease(OR=1.093,95%CI 1.053~1.136,P<0.05).With increasing age,the risk of disease increased.Conclusion The age of onset is the risk factors for ILD involvement in RA.