摘要
目的探讨类风湿关节炎(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,加深对RA肺间质病变的认识。方法回顾我院2002年1月至2006年1月161例住院RA患者的临床资料,包括类风湿因子(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。结果本组类风湿关节炎患者中并发肺间质纤维化25例．占全部类风湿关节炎的15%；25例RA并发肺间质纤维化者中,RF强阳性18例,ESR增高23例,CRP增高19例,血小板增高14例,低氧血症18例,23例患者呼吸系统疾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联,但病情较原发性肺纤维化轻,经过适当的治疗,病情一般能够得到控制,只有3例死亡,占12%,死亡原因为Ⅰ型呼吸衰竭。结论RA患者应尽早做肺HRCT及肺功能检查,以早期诊断和治疗肺部病变,尤其是RF强阳性的RA患者。
Objective To explore the occurrence, clinical characteristics, pulmonary function, radiographic findings and the associated factors of pulmonary interstitial fibrosis in rheumatoid arthritis（RA） to build up knowledge for early diagnosis. Methods The clinical data of 161 admitted RA patients from January 2002 to January 2006 were analyzed retrospectively including rheumatoid factor（RF）,blood-gas analysis,chest X-ray,chest HRCT,pulmonary function tests. Results 25 RA patients concurring with interstitial pulmonary fibrosis（IPF） accounted for 15% of total RA patients. Among the 25 RA patients with IPF, 18 cases were with strongly positive RF, 23 cases with elevated ESR, 19 cases with elevated CRP, 14 cases with elvated platelets account and 18 cases with hypoxemia. Respiratory symptoms presented after the joint symptoms. IPF was related to the severity of rheumatoid arthritis. When treated appropriately, IPF secondary to RA could be well controlled. Only 3 deaths occurred in this study with the mortality of 12%. The cause of the death was type Ⅰ respiratory failure. Conclusions HRCT and pulmonary function test should be taken early in order to get early diagnosis and treatment, especially in those with strongly positive RF.
出处
《北京医学》
CAS
2006年第10期593-595,共3页
Beijing Medical Journal
关键词
类风湿关节炎
肺间质纤维化
Rheumatoid arthritis（RA） Interstitial pulmonary fibrosis（IPF）
