肺部参与新诊断和未治疗的类风湿性关节炎和牛皮性关节炎:一个前性的纵向研究
Lone Winter1,2, Simon M Petzinna3, Dirk Skowasch4
1Department of Rheumatology and Clinical Immunology, Clinic of Internal Medicine III, University Hospital Bonn, Bonn, Germany. S4lowint@uni-bonn.de.
新型风湿性关节炎 (RA) 和牛皮性关节炎 (PsA) 患者的肺部感染很常见,通常没有症状. 减少疾病活动并不能保证改善肺功能,强调需要更好的监测.
科学领域:
- 类风湿病学 类风湿病学
- 肺部病理学 肺部病理学
- 临床医学 临床医学
背景情况:
- 类风湿性关节炎 (RA) 和牛皮性关节炎 (PsA) 是一种全身性自身免疫性疾病,具有已知的关节外表现.
- 肺部干扰是RA和PsA中公认的并发症,但其纵向过程和与疾病活动的关系需要进一步调查.
研究的目的:
- 在12个月内对新诊断的RA和PsA患者进行纵向评估肺部参与.
- 确定监测肺部变化的潜在生物标志物.
- 建立一个诊断算法来跟踪这些患者群体的肺部健康状况.
主要方法:
- 新诊断的RA和PsA患者每季度接受临床,实验室,肺功能测试 (PFTs) 和胸部放射 (CXR) 评估,持续一年.
- 为了进行比较,包括了对照组.
- 数据分析的重点是研究期间的PFT,放射性发现和炎症标志物 (例如CRP) 的变化.
主要成果:
- 在基线时,37%的关节炎患者 (50%的RA,22.7%的PsA) 患有放射性肺部干扰,大多是无症状的.
- 在64%的患者和23.1%的对照人群中观察到病态呼吸幅度的减少 (p < .001).
- 在随访期间,肺功能测试,疾病活动得分和6分钟步行距离显著改善,但在PFT结果和疾病活动或药物之间没有发现任何关联.
结论:
- 在新诊断的RA和PsA患者中,明显的,主要是无症状的肺部干扰是普遍存在的.
- 肺功能与疾病活动或药物治疗没有相关性,这表明疾病的进展是独立的.
- 这些发现强调需要敏感的生物标志物和优化监测策略,以对RA和PSA肺部并发症进行监测.
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