Hills E A, Davies S, Geary M
Thorax. 1979 Dec;34(6):755-61. doi: 10.1136/thx.34.6.755.
An investigation of lung function was carried out in 99 randomly selected patients with calssic or definite rheumatoid arthritis and in 60 control subjects matched for age, sex, and smoking habits. Mean FEV1 and mean VC were both significantly lower in the rheumatoid patients due to significant differences for women but mean FEV/VC ratio was 73.0% in the rheumatoid group and 72.1% in the control. Steady-state transfer factor was significantly greater in the normal men than in the comparable rheumatoid group, but there was no difference for women. After excluding patients with FEV1 less than 80% predicted normal and patients with low compliance, 72 rheumatoid patients and 45 controls provided series of tracings that could be assessed for a fall in Cdyn of 20% between 20 cycles and 60 cycles a minute. Dynamic compliance was not significantly different in any group at any rate of respiration. Fourteen of 72 rheumatoid patients and three of 45 controls showed frequency dependence (FDC). After the age of 50 the prevalence in the rheumatoid groupwas 11/38 and in the control group 2/27. This difference was significant (P less than 0.05). FDC was not consistently related to other abnormalities of lung function or to the duration, severity, or treatment of the rheumatoid arthritis. In various categories of smoking habits, dust exposure, or allergic tendency, the prevalence was always greater in the rheumatoid group. This provides evidence of patchy involvement of small airways, or alveoli and connective tissue, by the rheumatoid process.
对99例随机选取的典型或确诊类风湿关节炎患者以及60例年龄、性别和吸烟习惯相匹配的对照者进行了肺功能调查。类风湿关节炎患者的平均第一秒用力呼气容积(FEV1)和平均肺活量(VC)均显著降低,这是由于女性存在显著差异,但类风湿关节炎组的平均FEV1/VC比值为73.0%,对照组为72.1%。正常男性的稳态转移因子显著高于相应的类风湿关节炎组,但女性之间无差异。排除FEV1低于预测正常值80%的患者和顺应性低的患者后,72例类风湿关节炎患者和45例对照者提供了一系列描记图,可用于评估每分钟20次呼吸至60次呼吸之间动态顺应性(Cdyn)下降20%的情况。在任何呼吸频率下,任何组的动态顺应性均无显著差异。72例类风湿关节炎患者中有14例,45例对照者中有3例表现出频率依赖性(FDC)。50岁以后,类风湿关节炎组的患病率为11/38,对照组为2/27。这种差异具有统计学意义(P<0.05)。FDC与肺功能的其他异常或类风湿关节炎的病程、严重程度或治疗无一致相关性。在各种吸烟习惯、接触粉尘或过敏倾向类别中,类风湿关节炎组的患病率总是更高。这为类风湿病变对小气道、肺泡和结缔组织的散在累及提供了证据。