查与类风湿性关节炎相关的间歇性肺病:目前的证据和日常临床使用所需的下一步措施
Lauren A O'Keeffe1, Liya Sisay Getachew2, Suchita P Nety3
1L.A. O'Keeffe, MS, Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, MA, USA.
The Journal of rheumatology
|December 1, 2025
概括
对于具有风险因素的RA患者,条件建议对类风湿性关节炎相关的间歇性肺病 (RA-ILD) 进行查. 需要进一步的试验来确定通过查检测到的亚临床RA-ILD的干预措施.
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:
- 类风湿性关节炎相关的间歇性肺病 (RA-ILD) 是一种严重的表现,影响生活质量和生存.
- 高达15%的类风湿性关节炎 (RA) 患者会发展出临床显著的RA-ILD,更多患者表现出亚临床疾病.
- 常见的RA-ILD模式包括通常的间歇性肺炎 (UIP) 和非特异性间歇性肺炎.
研究的目的:
- 审查目前用于查类风湿性关节炎相关间歇性肺病 (RA-ILD) 的证据.
- 概述必要的下一步步骤,以证明在特定患者亚组中进行RA-ILD查的合理性.
- 讨论RA-ILD查的影响和未来的研究需求.
主要方法:
- 关于RA-ILD查现有文献的叙事综述.
- 对RA-ILD目前的指导方针和风险因素的分析.
- 检查与RA-ILD的遗传和生物标志物关联.
主要成果:
- 2023年的指导方针有条件地建议查具有风险因素的RA患者,如男性性别,年龄较大,吸烟和RA自身抗体升高.
- MUC5B促进体变体是RA-ILD的重要遗传风险因素,特别是UIP亚型.
- 建议的查策略显示了准确的RA-ILD检测的潜力.
结论:
- 对于风险RA患者,条件建议对RA-ILD进行查.
- 需要进一步的研究来解决查的后果,例如成本和患者焦虑.
- 临床试验对于确定可以改变亚临床RA-ILD自然史的干预措施至关重要.
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