目的 探讨类风湿关节炎(RA)患者并发肺间质病变(ILD)(RA-ILD)的临床特点.方法 回顾性分析2012年1月至2014年6月大连市中心医院风湿免疫病房住院的171例RA患者,按照是否合并肺间质病变分为单纯RA组(145例)和RA-ILD组(26例),比较两组临床资料、实验室检查、影像学检查等指标.结果 ILD在RA中的发生率为15.2％.与单纯RA患者相比,RA-ILD患者发病年龄大,病程长,疾病活动度评分(DAS28)高(P均＜0.05).其中15例(57.7％).患者在检出ILD时无呼吸系统症状.实验室检查指标中,红细胞沉降率(ESR)、C-反应蛋白(CRP)、类风湿因子(RF)、抗环瓜氨酸多肽抗体(ACPA)在RA-ILD组均显著增高(P均＜0.05).多因素分析显示,年龄(OR=1.089,95％CI 1.036～1.128,P＜0.05)和RF(OR=3.489,95％CI 1.352～8.952,P＜0.05)是RA-ILD的危险因素.结论 ILD是RA的常见并发症,与疾病的高活动度相关.年龄和RF是其发生的危险因素.%Objective To investigate the clinical characteristics of rheumatoid arthritis-associated interstitial lung disease (RA-ILD).Methods A total of 171 RA patients were classified as 2 groups:without RA group (RA-no ILD,n =145) and the RA-ILD (n =26) group,and their clinical and laboratory data were analyzed retrospectively.Results The incidence of RA-ILD was 15.2％.The patients with RA-ILD had older age,longer disease duration and higher DAS28 scores than the RA patients without ILD (P＜0.05).A proportion of 57.7％ RA-ILD patients were asymptomatic at the onset of the diseases.Higher levels of erythrocyte sedimentation rate (ESR),C-reactive protein(CRP),rheumatoid factor (RF) as well as anti-cyclic citrullinated peptide(anti-CCP) antibodies were found in the RA-ILD group than in the RA-no ILD group (P＜0.05).Multivariable analysis indicated that the correlative risk factors of RA-ILD were age and RF levels.Conclusion The presence ofILD is a common complication of RA and positive correlation exists between ILD and high disease activity of RA.Both of age and increased RF levels are risk factors.
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