在风湿性关节炎患者中,ACPA是CT证明的肺结节进展的主要风险因素
Güllü Sandal Uzun1, Yasin Sarıkaya2, Sevtap Arslan2
1Faculty of Medicine, Division of Rheumatology, Department of Internal Medicine, Hacettepe University, Ankara, Turkey. gullusandaluzun@gmail.com.
Clinical rheumatology
|January 30, 2025
概括
类风湿性肺结节 (RPNs) 可以在类风湿性关节炎 (RA) 诊断之前出现. 抗素蛋白抗体 (ACPA) 阳性是RPN发生和进展的关键因素,独立于RA治疗.
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:
- 类风湿性关节炎 (RA) 是一种慢性炎症性疾病.
- 风湿性肺结节 (RPNs) 是一种已知的RA的关节外表现.
- 了解RPN特征和进展因素对于患者管理至关重要.
研究的目的:
- 为了描述类风湿性肺结节 (RPNs).
- 在类风湿性关节炎 (RA) 患者中识别与RPN进展相关的因素.
- 为了研究血清阳性和RPN特征之间的关系.
主要方法:
- 对204名RA患者 (2010-2018年) 的胸部CT扫描进行了回顾性分析.
- 放射性评估结节的特征,包括大小,腔位和随时间变化.
- 统计分析以确定血清阳性,RA治疗和RPN进展之间的关联.
主要成果:
- 在RA诊断之前,在10.2%的患者中检测到肺结节.
- 血清阳性患者的结节数量更高,主导结节直径更大,洞穴更多.
- 反素蛋白抗体 (ACPA) 阳性与RPN进展独立相关 (OR 3.69).
- 传统的合成疾病修饰抗风湿药物 (Cs-DMARDs) 和生物/向合成DMARDs (b/ts-DMARDs),包括抗TNF药物,没有影响结节的进展.
结论:
- 类风湿性肺结节可以在RA诊断之前出现.
- 血清阳性,特别是ACPA阳性,是RPN发生和进展的重要独立风险因素.
- 目前的RA治疗 (Cs/b/ts-DMARDs) 似乎没有影响RPN进展.
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