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类风湿关节炎患者亚临床间质性肺疾病的筛查:功能和放射学方法。

Screening for Subclinical Interstitial Lung Disease in Rheumatoid Arthritis Patients: Functional and Radiological Methods.

作者信息

Abdelwahab Heba Wagih, Shalabi Nesrein M, Rashad Ghoneim Mahitab Mohamed, Farrag Nesrine Saad, Hamdy Fatma, Elhoseiny Fatma, Ali Raed Elmetwally

机构信息

Department of Chest Medicine, Mansoura University, Mansoura, Egypt.

Department of Radio-Dignosis and Interventional Radiology, Mansoura University, Mansoura, Egypt.

出版信息

Turk Thorac J. 2022 Jul;23(4):261-267. doi: 10.5152/TurkThoracJ.2022.21263.

Abstract

OBJECTIVE

Interstitial lung disease is the most frequent lung symptom of rheumatoid arthritis and is a significant contributor to morbid- ity. As a result, the target of this research was to measure the frequency of radiological and functional abnormalities in rheumatoid arthritis patients who did not have any respiratory symptoms.

MATERIAL AND METHODS

This study consists of 30 patients diagnosed with rheumatoid arthritis. All involved cases were exposed to entire history taking and clinical examination. All patients were examined by high-resolution computed tomography and pulmonary function tests.

RESULTS

According to the computed tomography visual score, 73.3% showed interstitial lung disease. The most common abnormalities were reticular patterns (46.7%) followed by nodular patterns (40%) and septal lines (23.3%). However, 36% of the patients had a normal pulmonary function, while 32% had a small airway affection, 20% had restrictive lung disease, and 12% had obstructive lung disease. A significant association was found between supine expiratory volume and computed tomography visual score. Results showed no associa- tion between interstitial lung disease and all lung function test parameters.

CONCLUSION

Subclinical interstitial lung disease is frequent among rheumatoid arthritis patents. A combination of pulmonary func- tion tests with computed tomography is essential to enhance the recognition of subclinical interstitial lung disease as normal pulmonary function alone cannot exclude its presence.

摘要

目的

间质性肺疾病是类风湿关节炎最常见的肺部症状,也是导致发病的重要因素。因此,本研究的目的是测量无任何呼吸道症状的类风湿关节炎患者中放射学和功能异常的发生率。

材料与方法

本研究纳入30例确诊为类风湿关节炎的患者。所有纳入病例均进行了全面的病史采集和临床检查。所有患者均接受了高分辨率计算机断层扫描和肺功能测试。

结果

根据计算机断层扫描视觉评分,73.3%的患者显示间质性肺疾病。最常见的异常是网状影(46.7%),其次是结节影(40%)和间隔线(23.3%)。然而,36%的患者肺功能正常,32%的患者有小气道病变,20%的患者有限制性肺病,12%的患者有阻塞性肺病。仰卧位呼气量与计算机断层扫描视觉评分之间存在显著相关性。结果显示间质性肺疾病与所有肺功能测试参数之间无相关性。

结论

亚临床间质性肺疾病在类风湿关节炎患者中很常见。肺功能测试与计算机断层扫描相结合对于提高亚临床间质性肺疾病的识别至关重要,因为仅正常的肺功能不能排除其存在。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/13c0/9361088/d39ddd08502e/ttj-23-4-261_f001.jpg

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