摘要
目的:探讨类风湿关节炎(RA)相关间质性肺疾病(ILD)的胸部高分辨率CT(HRCT)表现,并探讨发生RA-ILD的临床及实验室危险因素。方法:根据是否合并ILD将接受胸部HRCT检查的471例连续性RA患者分为RA-ILD(n=273)组和非RA-ILD组(n=198)。分析RA-ILD患者的HRCT表现及两组患者临床资料及实验室指标的差异,并探讨RA患者发生ILD及RA-ILD患者进展为普通间质性肺炎(UIP)的危险因素。结果:RA-ILD组患者年龄更大,男性比例更高(P<0.05),且高血压、糖尿病的发生率更高(P<0.05)。RA-ILD组患者血沉、C反应蛋白、类风湿因子IgM、IgA水平均高于非ILD组(P<0.05)。RA-ILD患者的HRCT以小叶间隔增厚最为常见,其次为胸膜下线、网格影、磨玻璃影及蜂窝影,且蜂窝影多见于男性患者。多因素二分类逻辑回归结果发现年龄增大(OR=1.12,95%CI:1.09~1.15,P<0.001)、男性患者(OR=1.74,95%CI:1.04~2.93,P=0.036)及C反应蛋白增高(OR=1.01,95%CI:1.00~1.01,P=0.022)是发生RA-ILD的独立危险因素。RA-ILD患者中,各临床因素及实验室指标与发生UIP型间质性肺疾病均未见明显相关性。结论:年龄增大、男性及C反应蛋白增高可能是RA患者发生ILD的危险因素,且男性患者发生UIP概率更高。
Objective:To explore the HRCT finding of rheumatoid arthritis-related interstitial lung disease(RA-ILD),and explore the clinical and laboratory risk factors for the development of RA-ILD.Methods:471 consecutive RA patients who underwent chest HRCT examinations were divided into RA-ILD(n=273)group and non RA-ILD group(n=198)based on whether ILD was merged or not.The HRCT features of RA-ILD patients were analyzed,as well as the differences in clinical data and laboratory indicators between the two groups.Furthermore,the risk factors for the development of ILD in RA patients and usual interstitial pneumonia(UIP)in RA-ILD patients were explored.Results:The RA-ILD group had older age,a higher proportion of males(P<0.05),and a higher prevalence of hypertension and diabetes(P<0.05).Additionally,RA-ILD patients had higher levels of erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),rheumatoid factor IgM,and IgA compared to the non RA-ILD group(P<0.05).The most common HRCT findings in RA-ILD patients were interlobular septal thickening,followed by subpleural lines,reticular opacities,ground-glass opacities,and honeycombing.Honeycombing was more common in male patients.Multivariate Logistic regression analysis revealed that increasing age(OR=1.12,95%CI:1.09~1.15,P<0.001),male sex(OR=1.74,95%CI:1.04~2.93,P=0.036),and elevated CRP levels(OR=1.01,95%CI:1.00~1.01,P=0.022)were independent risk factors for the development of RA-ILD.There were no significant correlations between clinical factors and laboratory indicators with the occurrence of UIP-type interstitial lung disease in RA-ILD patients.Conclusion:In RA patients the presence of ILD is associated with older age,male,and elevated CRP levels,and the incidence of UIP is higher in male patients.
作者
郭丹丹
李林
贾霜
冯钰玲
王菲瑶
杨帆
唐鸿杰
李睿
GUO Dan-dan;LI Lin;JIA Shuang;FENG Yu-ling;WANG Fei-yao;YANG Fan;TANG Hong-jie;LI Rui(Department of Radiology,Nanchong Hospital of Traditional Chinese Medicine,Nanchong 637000,Sichuan,China;Department of Radiology,Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China)
出处
《川北医学院学报》
CAS
2024年第4期452-456,共5页
Journal of North Sichuan Medical College
基金
四川省科技厅科技计划项目(2021YJ0242)
四川省南充市科技局科研项目(22YYJCYJ0032)
川北医学院校级科研发展计划项目(CBY21-QA46)。
关键词
类风湿关节炎
间质性肺疾病
高分辨率CT
危险因素
Rheumatoid arthritis
Interstitial lung disease
High-resolution computed tomography
Risk factor
