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目的探讨类风湿关节炎(RA)并发肺间质纤维化的发生情况、临床特点、肺功能、影像学检查及相关因素,加深对RA肺间质病变的认识。方法回顾我院2002年1月至2006年1月161例住院RA患者的临床资料,包括类风湿因子(RF)、血气分析、胸部X线、肺高分辨CT(HRCT)、肺功能检查等。分析RA并发肺间质纤维化患者的特点。结果本组类风湿关节炎患者中并发肺间质纤维化25例．占全部类风湿关节炎的15%；25例RA并发肺间质纤维化者中,RF强阳性18例,ESR增高23例,CRP增高19例,血小板增高14例,低氧血症18例,23例患者呼吸系统疾患出现在关节炎之后：肺间质纤维化的发生与重症类风湿关节炎有关联,但病情较原发性肺纤维化轻,经过适当的治疗,病情一般能够得到控制,只有3例死亡,占12%,死亡原因为Ⅰ型呼吸衰竭。结论RA患者应尽早做肺HRCT及肺功能检查,以早期诊断和治疗肺部病变,尤其是RF强阳性的RA患者。
Objective To investigate the occurrence, clinical features, pulmonary function, imaging examination and related factors of rheumatoid arthritis (RA) complicated with pulmonary interstitial fibrosis and to deepen the understanding of RA interstitial lung disease. Methods The clinical data of 161 hospitalized RA patients from January 2002 to January 2006 in our hospital were retrospectively reviewed. They included rheumatoid factor (RF), blood gas analysis, chest X-ray, pulmonary high resolution CT (HRCT) and pulmonary function tests. Analysis of RA patients with pulmonary fibrosis characteristics. Results This group of rheumatoid arthritis patients with pulmonary fibrosis in 25 cases. Accounting for 15% of all rheumatoid arthritis; among 25 RA patients with pulmonary interstitial fibrosis, 18 were strongly positive for RF, 23 were ESR, 19 were CRP, 14 were thrombocytopenia, 18 were hypoxemia, 23 patients with respiratory diseases appear after arthritis: the occurrence of interstitial fibrosis and rheumatoid arthritis are associated, but the condition is lighter than primary pulmonary fibrosis, with appropriate treatment, the disease can be generally controlled, Only 3 patients died, accounting for 12%. The cause of death was Type I respiratory failure. Conclusions RA patients should do pulmonary HRCT and pulmonary function tests as early as possible to diagnose and treat pulmonary lesions in the early stage, especially those with strong RF.