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类风湿关节炎患者的肺部表现及其与疾病严重程度的相关性。

Pulmonary Manifestations in Patients of Rheumatoid Arthritis and its Correlation with Severity of Disease.

机构信息

Senior Professor;Corresponding Author.

Senior Resident.

出版信息

J Assoc Physicians India. 2023 Mar;71(3):11-12. doi: 10.5005/japi-11001-0195.

DOI:10.5005/japi-11001-0195
PMID:37354502
Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory disease of unknown etiology marked by symmetric, peripheral polyarthritis. RA has a prevalence of 1-2% in the general adult population. The mortality rate in patients with RA increases during the course of the disease, with a tendency to accelerate after 15 yearsAim: To study the pulmonary manifestations and their severity using [Disease Activity Score (DAS)-28 score] in patients of RAMaterials and methods: Present study was conducted in the Department of Medicine, Sardar Patel Medical College and Associated Group of Hospitals Bikaner, Bikaner, Rajasthan, India, on 100 patients. This study was a cross-sectional, observational study conducted over 1 year. Consecutive cases of RA patients attending the outpatient department or admitted to the medicine wards were selected according to the inclusion and exclusion criteriaResults: Pulmonary manifestation was present in a total of 38% of cases, while the remaining 62% of cases had no pulmonary manifestation. The presence of comorbidity and C-reactive protein (CRP) was significantly associated with pulmonary manifestation in RA patients. On high-resolution computed tomography (HRCT), the most common finding was interstitial lung disease (ILD) (60.5%), with usual interstitial pneumonia (UIP) as the most common pattern. On performing a pulmonary function test (PFT), 33 patients (86.84%) had an abnormal result, with restrictive as the most common patternConclusion: The patients of RA, especially those with advanced age, long duration of disease, male sex, and associated comorbidity, should be screened for pulmonary complications of RA using X-ray chest and PFT, supplemented by HRCT chest wherever required.

摘要

类风湿关节炎(RA)是一种病因不明的慢性炎症性疾病,其特征为对称性、外周多关节炎。RA 在普通成年人群中的患病率为 1-2%。RA 患者的死亡率在疾病过程中会增加,并且在 15 年后有加速的趋势。

目的

使用 [疾病活动评分(DAS)-28 评分] 研究 RA 患者的肺部表现及其严重程度。

材料和方法

本研究在印度拉贾斯坦邦比卡内尔的萨达尔·帕特尔医学学院和附属医院内科进行,共纳入 100 例患者。这是一项为期 1 年的横断面、观察性研究。根据纳入和排除标准,选择连续就诊于门诊或内科病房的 RA 患者。

结果

共有 38%的患者存在肺部表现,而其余 62%的患者无肺部表现。RA 患者的合并症和 C 反应蛋白(CRP)的存在与肺部表现显著相关。在高分辨率计算机断层扫描(HRCT)上,最常见的发现是间质性肺疾病(ILD)(60.5%),最常见的模式为寻常型间质性肺炎(UIP)。在进行肺功能检查(PFT)时,33 例患者(86.84%)的结果异常,最常见的模式为限制性。

结论

RA 患者,尤其是年龄较大、病程较长、男性和合并症的患者,应使用 X 射线胸部和 PFT 筛查 RA 的肺部并发症,必要时补充 HRCT 胸部检查。

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