放射性纤维化在类风湿性关节炎相关的间歇性肺病的进展
Dandan Chai1, Di Sun1, Yuanying Wang1
1Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
临床前间歇性肺病 (pILD) 在类风湿性关节炎 (RA) 患者中很常见. 糖尿病,高疾病活性和高级成像得分预测RA相关ILD中的纤维化进展.
科学领域:
- 类风湿病学 类风湿病学
- 肺部病理学 肺部病理学
- 放射学 放射学是一门学科.
背景情况:
- 类风湿关节炎相关的间歇性肺病 (RA-ILD) 是类风湿关节炎 (RA) 的严重并发症.
- 临床前间歇性肺病 (pILD) 可能是RA-ILD的早期表现,但其特征和进展尚不清楚.
- 确定RA-ILD及其进展的风险因素对于患者管理至关重要.
研究的目的:
- 在RA患者中确定RA-ILD,包括pILD的患病率.
- 确定RA-ILD发展的独立风险因素.
- 确定RA-ILD患者纤维化进展的独立风险因素.
主要方法:
- 对371名RA患者的回顾性分析,比较RA-ILD患者和没有RA-ILD患者.
- 多变量逻辑回归用于识别RA-ILD患病率的风险因素.
- 多变量考克斯回归用于确定RA-ILD患者纤维化进展的风险因素,随访HRCT数据.
主要成果:
- 32.3%的RA患者患有RA-ILD. 风险因素包括年龄超过60岁,吸烟,糖尿病 (DM),混合结合组织疾病 (MCTD),乳酸脱酶 (LDH) 升高,以及阳性抗循环化 (anti-CCP) 抗体.
- 在98名RA-ILD患者中,51%的患者在HRCT上表现出纤维化进展,平均时间为19.1个月.
- 纤维化进展的独立风险因素是DM,28个关节的疾病活动评分-红细胞沉积率 (DAS28-ESR) >5.1,和基线HRCT评分>5.0.0.
结论:
- 在RA患者中,RA-ILD很常见,并且经常进展.
- 糖尿病,较高的RA疾病活性和先进的基线HRCT发现是RA-ILD纤维化进展的重要风险因素.
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