Jian Xiang-dong, Guo Guang-ran, Ruan Yan-jun, Zhao Bo, Wang Yu-cai, Ning Qiong, Zhang Yuan-chao
Department of Rheumatology, Qilu Hospital, Shandong University, Jinan 250012, China.
Zhonghua Yi Xue Za Zhi. 2008 Jul 15;88(27):1884-7.
To observe the clinical feature of rheumatoid arthritis associated interstitial lung disease (RA-ILD) patients and changes of serum cytokines tumor growth factor (TGF)-beta 1, tumor necrosis factor (TNF)-alpha, insulin-like growth factor (IGF)-1, and platelet derived growth factor (PDGF)-AB.
The clinical manifestations, lung high resolution CT (HRCT), lung functions, blood gas and other relative laboratory findings of 30 RA-ILD patients and 35 RA patients were observed. ELISA was used to detect the levels of TGF-beta 1, TNF-alpha, IGF-1, and PDGF-AB. Thirty healthy volunteers were observed too as controls.
The clinical manifestations of RA-ILD patients were more serious than those of the RA patients. The ESR was faster, the serum C-reactive protein, rheumatoid factor (RF), and globulin levels higher, and pulmonary arterial pressure higher too in the RA-ILD patients than in the RA patients (all P<0.01). The main respiratory manifestations of the RA-ILD patients were cough, expectoration, chest distress, short breath, chest pain, change of breath sounds, Velcro râles, and dyspnea. The main lung HRCT findings included thickening of interlobular septum and bronchial wall, pachynsis pleurae, mosaic sign, bronchiectasis, emphysema, patching shadow, honeycombing, fibrous scar, etc. Pulmonary function test showed that the levels of vital capacity, forced vital capacity, maximum midexpiratory flow, and diffusing capacity of the lung for carbon monoxide of the RA-ILD patients were all significantly lower than those of the RA patients (all P<0.01). Arterial gas test showed that the PO2 of the RA-ILD patients was significantly lower than that of the RA patients (P<0.01). The TGF-beta 1; TNF-alpha, IGF-1, and PDGF-AB of both the RA-ILD and RA patients were all significantly higher than those of the healthy volunteers (all P<0.01), and the levels of these cytokines of the RA-ILD patients were all higher than those of the RA patients (all P<0.01).
The symptoms and signs of the RA-ILD patients are more serious, the lung HRCT changes more obvious, lung function decreases, and the levels of TGF-beta 1, TNF-alpha, IGF-1, and PDGF-AB increase.
观察类风湿关节炎相关间质性肺疾病（RA-ILD）患者的临床特征以及血清细胞因子肿瘤生长因子（TGF）-β1、肿瘤坏死因子（TNF）-α、胰岛素样生长因子（IGF）-1和血小板衍生生长因子（PDGF）-AB的变化。
观察30例RA-ILD患者和35例RA患者的临床表现、肺部高分辨率CT（HRCT）、肺功能、血气及其他相关实验室检查结果。采用酶联免疫吸附测定（ELISA）法检测TGF-β1、TNF-α、IGF-1和PDGF-AB的水平。另观察30名健康志愿者作为对照。
RA-ILD患者的临床表现较RA患者更为严重。RA-ILD患者的血沉更快，血清C反应蛋白、类风湿因子（RF）和球蛋白水平更高，肺动脉压也高于RA患者（均P<0.01）。RA-ILD患者主要的呼吸系统表现为咳嗽、咳痰、胸闷、气短、胸痛、呼吸音改变、Velcro啰音及呼吸困难。肺部HRCT主要表现为小叶间隔和支气管壁增厚、胸膜增厚、马赛克征、支气管扩张、肺气肿、斑片状阴影、蜂窝状改变、纤维瘢痕等。肺功能检查显示，RA-ILD患者的肺活量、用力肺活量、最大呼气中期流速和肺一氧化碳弥散量均显著低于RA患者（均P<0.01）。动脉血气检查显示，RA-ILD患者的动脉血氧分压（PO2）显著低于RA患者（P<0.01）。RA-ILD患者和RA患者的TGF-β1、TNF-α、IGF-1和PDGF-AB均显著高于健康志愿者（均P<0.01），且RA-ILD患者这些细胞因子的水平均高于RA患者（均P<0.01）。
RA-ILD患者的症状和体征更严重，肺部HRCT改变更明显，肺功能下降，且TGF-β1、TNF-α、IGF-1和PDGF-AB水平升高。
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