风湿性关节炎中的纤维化渐进性间歇性肺病:一项多中心意大利研究
Marco Sebastiani1, Vincenzo Venerito2, Elenia Laurino3
1Rheumatology Unit, Azienda Policlinico di Modena, University of Modena and Reggio Emilia, 41121 Modena, Italy.
Journal of clinical medicine
|November 25, 2023
概括
超过三分之一的类风湿性关节炎相关的间歇性肺病 (RA-ILD) 患者表现出渐进的纤维化模式,可能受益于抗纤维性疗法,如Nintedanib.
科学领域:
- 肺部病理学 肺部病理学
- 类风湿病学 类风湿病学
- 放射学 放射学是一门学科.
背景情况:
- 宁达达尼布在异常性肺纤维化以外的渐进性纤维化间歇性肺病 (PF-ILD) 中有效.
- 类风湿性关节炎相关的ILD (RA-ILD) 是一种可能有益的情况.
- 目前,RA-ILD患者中渐进性纤维化模式的患病率尚不清楚.
研究的目的:
- 为了确定RA-ILD患者纤维化进展模式的流行率.
- 为了确定与RA-ILD中渐进性纤维化模式相关的因素.
主要方法:
- 一项多中心,横截面的研究招募了134名RA-ILD患者,具有高分辨率计算机断层扫描确认和至少24个月的随访.
- 渐进性纤维化ILD被定义为强迫生命能力预测下降>10%和/或在24个月的成像中增加纤维变化.
- 呼吸系统症状被排除在外,以尽量减少回顾性分析中的偏差.
主要成果:
- 在36.6%的RA-ILD患者中发现了纤维化的渐进模式.
- 渐进性纤维化模式与通常的间歇性肺炎 (UIP) 放射性模式 (50.7%的病例) 有显著的关联.
- 在纤维化模式的患者中,48.5%的病例呈现进展.
结论:
- 超过三分之一的RA-ILD患者表现出纤维化的渐进模式,这表明抗纤维治疗可能有好处.
- 该研究的回顾性设计和排除呼吸道症状是局限性的.
- 尽管存在局限性,但研究结果突出了RA-ILD患者中可能受益于抗纤维化疗法的大量患者.
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