摘要
目的了解类风湿关节炎相关肺间质病变(RA-ILD)的危险因素。方法通过检索Pubmed、Sinomed、Embase、Wiley online library、中国生物医学文献数据库(CBM)、中国知网、万方数据库、维普数据库、NSTL开放学术资源系统网等搜集RA-ILD危险因素相关的文献,检索年限为建库至2021年1月1日,采用纽卡斯尔-渥太华质量评估量表(NOS)对纳入的文献进行质量评价,提取纳入的文献数据后,利用Review Manager 5.3和Stata SE12.0统计软件进行Meta分析。结果纳入的Meta分析的36篇文献,RA-ILD组有3280例,RA-nILD组有25510例。RA-ILD的发生率为6.25%,男性RA-ILD的风险是女性的2.51倍[OR(95%CI)=2.51(2.25,2.80)]。RA-ILD组患者的发病年龄均比RA-nILD组大7.47岁[56.50岁与49.04岁,95%CI(6.56,8.38)岁]。RA-ILD组平均病程比RA-nILD组长1.11年[7.73年与6.62年,95%CI(0.68,1.55)年]。吸烟的RA患者出现ILD的风险是非吸烟者的2.25倍[OR(95%CI)=2.25(2.01,2.52)]。ESR增快、CRP升高、DAS28-ESR升高均为RA-ILD中度危险因素(分别为SMD(95%CI)=0.25(0.18,0.31);SMD(95%CI)=(0.18,0.32);SMD(95%CI)=0.36(0.27,0.45)]。RF阳性及抗CCP抗体阳性的RA患者发生ILD风险分别是阴性者的1.71倍[OR(95%CI)=1.71(1.45,2.01)]、2.41倍[OR(95%CI)=2.41(1.80,3.23)]。结论男性、吸烟、高龄、长病程、ESR快、CRP高、DAS28-ESR高、RF及抗CCP抗体阳性是RA-ILD的危险因素。
Objective To evaluate the risk factors of rheumatoid arthritis associated interstitial lung disease(RA-ILD).Methods Databases including PubMed,Sinomed,Embase,Wiley Online library were searched to collect studies on risk factors of RA-ILD.The deadline of the search was January 12021.Newcastle-Ottawa Scale(NOS)was used to assess the literature quality,data was extracted and analyzed by Statistical software in eligible studies.Results This meta-analysis included 36 studies involving 3280 patients with RA-ILD and 25510 RA controls patients.The Incidence of RA-ILD was 6.25%.The risk of RA-ILD was 2.51 times greater in men than in women[OR(95%CI)=2.51(2.25,2.80)].The mean onset age of patients with RA-ILD was 7.47 years[56.50 vs 49.04,95%CI(6.56,8.38)]older than those of patients with RA-nILD.The mean duration of patients with RA-ILD was 1.11 years longer than that of patients with RA-nILD[7.73 vs 6.62,95%CI(0.68,1.55)].The risk of RA-ILD was two times greater in smoker than in non-smoker[OR(95%CI)=2.25(2.01,2.52]).Moderate evidence indicated that higher erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),disease activity score in 28 joints(DAS28)-ESR were risk factors for RA-ILD[Stan-dard Mean Difference(SMD)(95%CI)=0.25(0.18,0.31);SMD(95%CI)=0.25(0.18,0.32);SMD(95%CI)=0.36(0.27,0.45),respectively).The pooled[OR(95%CI)=1.71(1.45,2.01)]in rheumatoid factor(RF)positive and[OR(95%CI)=2.41(1.80,3.23)]anti-CCP antibody positive for the risk of RA-ILD.Conclusion Male,smoking,older age of disease onset,long disease duration,elevated erythrocyte sedimentation rate,high C-reactive protein level,high DAS28-ESR,positive RF and anti-cyclic peptide containing citrulline antibody were risk factors for RA-ILD.
作者
吴琦
栾慧杰
何娟
王庆文
Wu Qi;Luan Huijie;He Juan;Wang Qingwen(Department of Rheumatism and Immunology,Peking University Shenzhen Hospital,Shenzhen Key Laboratory of Immunity and Inflammatory Diseases,Guangdong 518000,China)
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2022年第9期607-614,共8页
Chinese Journal of Rheumatology
基金
国家自然科学基金项目(81974253,81901641)
广东省自然科学基金面上项目(2019A15-15011112)
广东省深圳市科创委重点基础研究(JCYJ20200109140203849)
广东省深圳市卫生健康委员会医防融合项目(010-2018-2019-YBXM-1499-01-0414)。
