Zayeni Habib, Haji-Abbasi Asghar, Foumani Seyed Ali Alavi, Tohidi Mehdi, Masooleh Irandokht Shenavar, Parsa Banafsheh Ghavidel, Aghaei Mehrdad, Hassankhani Amir, Parsa Pooneh Ghavidel, Maafi Alireza Amir
Rheumatology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Respiratory Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Lung India. 2016 Jan-Feb;33(1):49-52. doi: 10.4103/0970-2113.173062.
Interstitial lung disease (ILD) is a type of pulmonary manifestation in patients with rheumatoid arthritis (RA). Mostly RA-ILD has no symptoms and is only diagnosed by clinical examination, pulmonary function test (PFT), and high-resolution computed tomography (HRCT); hence it seems that the diagnosis of pulmonary involvement in early stages of RA is of great importance. Therefore, we decided to answer this question whether the evaluation of RA patients without pulmonary symptoms using methods such as PFT and HRCT are justifiable and reasonable or not.
We conducted a cross-sectional study in a referral rheumatology clinic in Razi hospital of Rasht, Iran. Forty-four consecutive patients, diagnosed with RA, were enrolled. Physical examination of the joints was performed by an rheumatologist. The activity of RA was evaluated in all patients by Disease Activity Score 28. An expert pulmonologist performed the respiratory examination in all participants. Then, all subjects were referred for chest X-ray, PFT, and HRCT of lungs.
Patients included in this study, 9 (20.45%) males and 35 (79.55%) females, were 21-73 years old and their mean age was 49 ± 13 years. Significant relation between PFT and respiratory complaints was observed (P = 0.016). PFT had significant relation with respiratory examinations (P = 0.009). Our results indicated a significant relation between disease activity rate and PFT (P = 0.038). While HRCT had any significant relation with above items.
We concluded, using PFT in the respiratory assessment of RA patients can be limited to persons with high disease activity, respiratory complaints, and positive findings in the clinical respiratory examination.
间质性肺病（ILD）是类风湿关节炎（RA）患者的一种肺部表现形式。大多数RA-ILD没有症状，仅通过临床检查、肺功能测试（PFT）和高分辨率计算机断层扫描（HRCT）来诊断；因此，RA早期肺部受累的诊断似乎非常重要。所以，我们决定回答这个问题，即使用PFT和HRCT等方法对无肺部症状的RA患者进行评估是否合理。
我们在伊朗拉什特市拉齐医院的转诊风湿病诊所进行了一项横断面研究。纳入了44例连续诊断为RA的患者。由一名风湿病学家进行关节的体格检查。通过疾病活动评分28对所有患者的RA活动度进行评估。由一名专业肺科医生对所有参与者进行呼吸检查。然后，所有受试者均接受胸部X线、PFT和肺部HRCT检查。
本研究纳入的患者年龄在21至73岁之间，平均年龄为49±13岁，其中男性9例（20.45%），女性35例（79.55%）。观察到PFT与呼吸主诉之间存在显著相关性（P = 0.016）。PFT与呼吸检查之间存在显著相关性（P = 0.009）。我们的结果表明疾病活动率与PFT之间存在显著相关性（P = 0.038）。而HRCT与上述各项均无显著相关性。
我们得出结论，在RA患者的呼吸评估中使用PFT可仅限于疾病活动度高、有呼吸主诉且临床呼吸检查有阳性发现的患者。
