Hassan W U, Keaney N P, Holland C D, Kelly C A
Department of Rheumatology, Leicester Royal Infirmary, United Kingdom.
Ann Rheum Dis. 1994 Aug;53(8):511-4. doi: 10.1136/ard.53.8.511.
To investigate the prevalence of airways obstruction and bronchial reactivity to inhaled methacholine in rheumatoid arthritis patients and unselected controls. The control population consisted of patients attending the rheumatology department for minor degenerative joint problems.
One hundred patients with rheumatoid arthritis (RA) [72 (72%) women, 28 (28%) men; mean (SD) age 58 (10) years] and fifty controls [30 (60%) women, 20 (40%) men; mean (SD) age 56 (9) years] were studied. Detailed medical, smoking and drug histories were taken; skin prick tests were performed to assess atopy and chest and hand radiographs were performed. Spirometry, flow volume loops and gas transfer factor measurement were performed to detect airflow obstruction and methacholine inhalation tests were carried out to assess bronchial reactivity.
There was no significant difference between rheumatoid arthritis patients and the controls in age, sex, smoking status and atopy on skin prick testing (p < 0.05). A significantly higher number of patients with RA had a history of wheeze compared with the controls (18% v 4%, p < 0.05). FEV1, FVC, FEV1/FVC, FEF25-75%, FEF25%, FEF50% and FEF75% were all significantly lower in the rheumatoid arthritis group (p < 0.05). A significantly higher number of patients with RA compared with controls showed bronchial reactivity to inhaled methacholine [55 (55%) v 8 (16%), p < 0.05]. FEV1, FVC, FEV1/FVC, FEF25-75%, FEF25%, FEF50% and FEF75% were all significantly lower among the patients with RA achieving PD20 FEV1 to inhaled methacholine (p < 0.05).
In unselected rheumatoid arthritis patients both airflow obstruction and bronchial reactivity are significantly increased compared with controls.
调查类风湿关节炎患者及未经过挑选的对照组中气道阻塞的患病率以及对吸入乙酰甲胆碱的支气管反应性。对照组人群由因轻度退行性关节问题到风湿科就诊的患者组成。
研究了100例类风湿关节炎（RA）患者[72例（72%）女性，28例（28%）男性；平均（标准差）年龄58（10）岁]和50例对照组患者[30例（60%）女性，20例（40%）男性；平均（标准差）年龄56（9）岁]。记录详细的病史、吸烟史和用药史；进行皮肤点刺试验以评估特应性，并拍摄胸部和手部X光片。进行肺量测定、流量容积环和气体转移因子测量以检测气流阻塞，并进行乙酰甲胆碱吸入试验以评估支气管反应性。
类风湿关节炎患者与对照组在年龄、性别、吸烟状况和皮肤点刺试验的特应性方面无显著差异（p<0.05）。与对照组相比，有喘息病史的RA患者数量显著更多（18%对4%，p<0.05）。类风湿关节炎组的第一秒用力呼气容积（FEV1）、用力肺活量（FVC）、FEV1/FVC、25%～75%用力呼气流量（FEF25-75%）、FEF25%、FEF50%和FEF75%均显著降低（p<0.05）。与对照组相比，对吸入乙酰甲胆碱表现出支气管反应性的RA患者数量显著更多[55例（55%）对8例（16%），p<0.05]。在对吸入乙酰甲胆碱达到PD20 FEV1的RA患者中，FEV1、FVC、FEV1/FVC、FEF25-75%、FEF25%、FEF50%和FEF75%均显著降低（p<0.05）。
与对照组相比，未经挑选的类风湿关节炎患者的气流阻塞和支气管反应性均显著增加。
