Allain J, Saraux A, Guedes C, Valls I, Devauchelle V, Le Goff P
Rheumatology Department (1), La Cavale Blanche Hospital, Brest, France.
Rev Rhum Engl Ed. 1997 Oct;64(10):531-7.
To evaluate the prevalence of symptomatic bronchiectasis in patients with rheumatoid arthritis.
Cross-sectional retrospective study of 453 rheumatoid arthritis patients. All patients completed a questionnaire designed to detect manifestations of bronchiectasis and had a chest film taken. Computed tomography of the chest was performed in those patients whose chest film was normal.
Thirteen patients (2.9%), all female, had symptoms that met Walker's criteria for definite (n = 7) or probable (n = 6) bronchiectasis. Symptom onset was during childhood or adolescence in 69% of cases and antedated the first symptoms of rheumatoid arthritis in all patients but one. Six of the 13 patients (46%) had chest film abnormalities suggestive of bronchiectasis, and three of the remaining seven patients had abnormal computed tomography findings, yielding a total of nine cases of bronchiectasis confirmed by imaging studies among the 13 patients with suggestive symptoms (69%). This proportion rose to 90% when the three patients who failed to come to their computed tomography appointment were excluded.
Using a methodological approach similar to that previously used by pneumologists, we found a 2.9% prevalence of symptomatic bronchiectasis in a population of hospitalized rheumatoid arthritis patients, which is higher than the 0.03% prevalence previously reported in the population at large.
评估类风湿关节炎患者中症状性支气管扩张的患病率。
对453例类风湿关节炎患者进行横断面回顾性研究。所有患者均完成了一份旨在检测支气管扩张表现的问卷,并拍摄了胸部X光片。胸部X光片正常的患者进行了胸部计算机断层扫描。
13例患者(2.9%),均为女性,有符合沃克明确(n = 7)或可能(n = 6)支气管扩张标准的症状。69%的病例症状发作于儿童期或青春期,且在除1例患者外的所有患者中,症状早于类风湿关节炎的首发症状。13例患者中有6例(46%)胸部X光片有提示支气管扩张的异常表现,其余7例患者中有3例计算机断层扫描结果异常,在13例有提示症状的患者中,共有9例经影像学检查确诊为支气管扩张(69%)。排除3例未前来进行计算机断层扫描的患者后,这一比例升至90%。
采用与肺病专家先前使用的方法类似的方法,我们发现住院类风湿关节炎患者中症状性支气管扩张的患病率为2.9%,高于此前在普通人群中报告的0.03%的患病率。