在类风湿性关节炎中间歇性肺病和支气管切除症的患病率:系统性审查和元分析
Jonas Aggerholm Baekdal1, Laurits Kramer Janns1, Erik Sören Halvard Hansen1
1Respiratory Research Unit Hvidovre, Department of Respiratory Medicine, Copenhagen University Hospital - Hvidovre, Denmark.
概括
间歇性肺病 (ILD) 和支气管病在风湿性关节炎 (RA) 患者中很常见,随着疾病持续时间的增加而增加. 建议在RA患者有呼吸道症状或疾病持续时间超过5年时进行早期HRCT查,以便及时进行干预.
科学领域:
- 类风湿病学 类风湿病学
- 肺部病理学 肺部病理学
- 医疗成像医学成像
背景情况:
- 类风湿性关节炎 (RA) 与间歇性肺病 (ILD) 和支气管病的风险更高有关.
- 在RA患者中早期发现这些肺部疾病对于有效管理至关重要.
研究的目的:
- 在被诊断为RA的个人中确定ILD和支气管病的流行率.
- 分析这些疾病的患病率与RA持续时间和C反应蛋白 (CRP) 水平等因素之间的关系.
主要方法:
- 在PubMed,Embase和谷歌学者中进行了系统的文献审查.
- 在RA患者中使用高分辨率计算机断层扫描 (HRCT) 的研究是按照PRISMA指南进行选的.
- 使用随机效应元回归来估计患病率及其与RA持续时间和CRP的关联.
主要成果:
- 分析了24项研究,其中包括2532名RA患者.
- 在RA诊断时ILD的患病率为8.5%,诊断后每年增加3.0%.
- 在RA诊断时支气管切除症的患病率为8.2%,诊断后每年增加1.1%,与CRP水平有很强的相关性.
结论:
- 炎症性肺炎和支气管炎症是RA的常见肺部并发症,特别是在长期病例中,可能是由于慢性炎症.
- 高分辨率计算机断层扫描 (HRCT) 建议在RA患者出现呼吸系统症状或在RA超过五年.
- 这种查方法可以帮助早期发现临床前ILD,并促进及时的治疗干预.
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