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[类风湿关节炎的心脏和肺部表现]

[Cardiac and pulmonary manifestations in rheumatoid arthritis].

作者信息

Yamakido M, Ishioka S, Takeda M

机构信息

2nd Department of Internal Medicine, Hiroshima University School of Medicine.

出版信息

Nihon Rinsho. 1992 Mar;50(3):570-5.

PMID:1588750
Abstract

Pericarditis may be the most common cardiac manifestation in RA patients and the incidence in autopsy cases is more than 30%. Pericardial effusion shows low sugar and complement level and high level of LDH and gamma-globulin. The administration of corticosteroids has been successfully used in the treatment of rheumatoid pericarditis. The pulmonary involvement in RA include pleuritis, nodules and interstitial lung disease. Interstitial lung disease in RA patients appears to run a continuum from mild pneumonitis to severe pulmonary fibrosis and occasionally it include bronchiolitis obliterans organizing pneumonia (BOOP) which is sensitive to corticosteroid therapy. Although open lung biopsy is the definitive procedure for proving the diagnosis of interstitial lung disease, open lung is now being complemented or replaced by transbronchial lung biopsy and bronchoalveolar lavage (BAL). Corticosteroids will be effective to BOOP definitely and in general usual interstitial pneumonia (UIP) is resistant to treatment. In addition to the primary pulmonary manifestations of RA, anti-rheumatic drug reactions in the lung may be associated.

摘要

心包炎可能是类风湿关节炎(RA)患者最常见的心脏表现,尸检病例中的发病率超过30%。心包积液显示低糖和补体水平,以及高水平的乳酸脱氢酶(LDH)和γ-球蛋白。皮质类固醇已成功用于治疗类风湿性心包炎。RA的肺部受累包括胸膜炎、结节和间质性肺疾病。RA患者的间质性肺疾病似乎呈现出从轻度肺炎到严重肺纤维化的连续过程,偶尔还包括对皮质类固醇治疗敏感的闭塞性细支气管炎伴机化性肺炎(BOOP)。虽然开胸肺活检是确诊间质性肺疾病的决定性方法,但现在经支气管肺活检和支气管肺泡灌洗(BAL)正在补充或取代开胸肺活检。皮质类固醇对BOOP肯定有效,而一般的普通间质性肺炎(UIP)对治疗有抵抗性。除了RA的原发性肺部表现外,肺部的抗风湿药物反应也可能与之相关。

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