RA-ILD与临床和实验室指标相关性研究

目的收集类风湿关节炎合并肺间质病变(RA-ILD)患者的相关临床指标、实验室指标和肺部影像学表现等临床资料,分析这些因素与RA-ILD的发生和发展的关系,为RA-ILD的诊疗提供一定的临床依据。方法回顾性收集2014年1月-2015年1月在新疆维吾尔自治区人民医院风湿免疫科住院的RA患者,一般资料、临床表现、实验室指标和影像学检查。结果 1 204例RA患者中44例发生ILD,占21.6%。6例胸闷、气短;6例有咳嗽、咳痰;6例听诊有Velcro音。比较发现RA-ILD组咳嗽咳痰、胸闷气短、Velcro音的发生率高于单纯RA组(P0.05)。RA-ILD组患者肺HRCT最常见的表现是磨玻璃影。2 RA-ILD组的平均病程、年龄明显大于单纯RA组(P0.05)。3 RA-ILD组白细胞、血红蛋白、血小板、DAS28、ESR、CRP、C3、C4、RF、GPI较单纯RA组差异无统计学意义(P0.05)。4 RA-ILD组抗CCP抗体滴度显著大于单纯RA组(P0.05)。5比较两组AKA阳性率差异有统计学意义(P0.05),而抗SSA抗体阳性率、抗核抗体阳性率差异无统计学意义(P0.05)。结论 RA-ILD患者年龄大、平均病程长,大部分临床表现不明显,需及时完善HRCT,早期诊断和治疗。高抗CCP抗体滴度、ANA阳性可能与RA-ILD的发生相关。

Clinical and laboratory correlation study of rheumatoid arthritis combined with interstitial lung disease

Objective To analyze the relationship between these factors and occurrence and development of RA-ILD by collecting the relevant clinical and laboratory data of rheumatoid arthritis with interstitial lung disease (RA-ILD)patients. Methods The clinical data of hospitalized patients with RA from January 2014 to January 2015 were retrospectively analyzed,including its population information,clinical manifestation,laboratory and imaging ex-amination. Results (1)44 cases occurred with RA-ILD in 204 patients,accounting for 21. 6% . There were 6 ca-ses of chest tightness and shortness of breath,6 cases of cough and sputum,and 6 cases with Velcro rales. Compared the RA-ILD group,the incidence of Velcro sound was higher than patients without ILD(P < 0. 05). One of the most common HRCT of the lung in the RA-ILD group was ground glass shadow.(2)The average duration and age of the RA-ILD group were significantly greater than those of the RA group(P < 0. 05).(3)There was no significant differ-ence in white blood cells,hemoglobin,platelet,DAS28,ESR,CRP,C3,C4,RF and GPI between the two groups (P > 0. 05).(4)The level of anti-CCP was significantly higher in the RA-ILD group than in the RA group(P <0. 05).(5)The positive rate of anti-AKA and anti-nuclear antibody showed statistical significance(P < 0. 05),but there was no significant difference in anti-SSA antibody(P > 0. 05). Conclusion RA patients with ILD are more common with elderly age and longer average duration,but most of the clinical symptoms is not obvious. HRCT can provide a useful tool for early diagnosis and treatment in time. High titer anti-CCP,AKA positive,positive ANA may be associated with the occurrence of RA-ILD.