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类风湿关节炎相关间质性肺疾病的危险因素分析 被引量:7

Analysis of the risk factors in rheumatoid arthritis-associated interstitial lung disease
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摘要 目的:探讨类风湿关节炎相关性间质性肺疾病(RA-ILD)的CT表现与实验室指标之间相关性。方法:搜集本院确诊为类风湿性关节炎(RA)并行胸部CT检查的患者178例,评估肺内间质性病变(ILD)的CT征象,搜集患者RF、ESR、抗环瓜氨酸肽抗体(ACCPA)等实验室结果,分析CT征象与实验室指标之间相关性。结果:ILD阳性组RF、ESR值[(129.76±62.54)U/mL、(60.22±35.42)mm/h]明显高于阴性组[(103.22±58.46)U/mL、(39.83±28.41)mm/h],蜂窝、小叶间隔增厚阳性组RF值[(148.89±54.45)U/mL、(153.66±58.12)U/mL]明显高于阴性组[(119.41±62.82)U/mL、(118.23±61.90)U/mL],小叶间隔增厚、淋巴结肿大阳性组ESR值[(73.83±30.19)mm/h、(69.67±37.00)mm/h]明显高于阴性组[(51.73±34.65)mm/h、(48.85±32.12)mm/h],差异有统计学意义(P均<0.05)。网格影、蜂窝阳性组ACCPA值(≥200 U/mL、≥200 U/mL)明显高于阴性组(121.2 U/mL、156.6 U/mL),而胸膜下线阳性组ACCPA值(46.6 U/mL)明显低于阴性组(186.8 U/mL),差异有统计学意义(P均<0.05)。IP患者中,吸烟人数比例(10/82)、ACCPA值(180.0 U/mL)明显高于非IP组(4/96、129.7U/mL),差异有统计学意义(P均<0.05),IP累及范围评分与RF、ESR值呈正相关,差异有统计学意义(P<0.05)。结论:吸烟、高ACCPA值是IP的危险因素,RF、ESR升高是肺内受累严重程度的危险因素;小叶间隔增厚、淋巴结肿大提示RA可能处于活动期,胸膜下线出现提示RA可能处于相对静止期。 Objective:To investigate the correlation between the CT signs and laboratory indexes of rheumatoid arthritis-associated interstitial lung disease(RA-ILD).Methods:A total of 178 patients were collected,who were diagnosed as rheumatoid arthritis(RA)and underwent chest CT scan in our hospital.The CT signs of interstitial lung disease(ILD)were evaluated,patients’laboratory results of RF,ESR and ACCPA value were collected,and the correlations between CT signs and laboratory indexes were analyzed.Results:The RF and ESR value of patients in ILD positive group(129.76±62.54 U/mL、60.22±35.42 mm/h)were significantly higher than those in negative group(103.22±58.46 U/mL、39.83±28.41 mm/h).The RF value of patients in alveolate and interlobular septal thickening positive group(148.89±54.45 U/mL、153.66±58.12 U/mL)were significantly higher than those in negative group(119.41±62.82 U/mL、118.23±61.90 U/mL).The ESR value of patients in interlobular septal thickening and lymph node enlargement positive group(73.83±30.19 mm/h、69.67±37.00 mm/h)were significantly higher than those in negative group(51.73±34.65 mm/h、48.85±32.12 mm/h),and the differences were statistically significant(all P<0.05).The ACCPA value of patients in reticular shadow and alveolate positive group(≥200 U/mL、≥200 U/mL)were significantly higher than those in negative group(121.2 U/mL、156.6 U/mL),while the ACCPA value of patients in subpleural line positive group(46.6 U/mL)was significantly lower than that in negative group(186.8 U/mL),and the difference was statistically significant(P<0.05).The proportion of smokers(10/82)and the ACCPA value in patients with IP(180.0 U/mL)were significantly higher than those without IP(4/96、129.7 U/mL),and the differences were statistically significant(both P<0.05).The involved extent of IP was positively correlated with RF and ESR value,and the difference was statistically significant(P<0.05).Conclusion:Smoking and high ACCPA value are the risk factors of IP,and the increased RF and ESR value are
作者 王超 雷洁 邱晓晖 章辉庆 WANG Chao;LEI Jie;QIU Xiao-hui(Department of Radiology,Bozhou People's Hospital,Anhui 236800,China)
出处 《放射学实践》 CSCD 北大核心 2021年第7期868-872,共5页 Radiologic Practice
关键词 类风湿性关节炎 间质性肺疾病 体层摄影术 X线计算机 类风湿因子 抗环瓜氨酸肽抗体 Rheumatoid arthritis Interstitial lung disease Tomography,X-ray computed Rheumatoid factors Anti cyclic citrullinated peptide antibody
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