Interstitial lung disease in recent onset rheumatoid arthritis
Interstitial lung disease in recent onset rheumatoid arthritis
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DOI：
10.1164/ajrccm.156.2.9609016
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发表时间：
1997-08-01
影响因子：
24.7
通讯作者：
Lake, FR
中科院分区：
文献类型：
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作者：
Gabbay, E;Tarala, R;Lake, FR
间质性肺病（ILD）与类风湿性关节炎（RA）相关;然而，患病率和自然史尚不明确。我们的目的是在病程少于2年的关节疾病患者中，使用一些敏感的技术来确定与RA相关的ILD的患病率。从社区和医院的风湿病学家中招募符合RA标准的患者，并使用以下措施进行评估：临床、肺生理学、放射学（胸部X线、高分辨率CT [HRCT]）、支气管肺泡损伤（BAL）和Tc-99 m-DTPA核扫描。研究了关节疾病持续时间（平均值+/- SD）为13.2 +/- 8.6个月的36例患者（25例女性和11例男性）。21/36例（58%）在一项或多项检查中发现与ILD一致的异常，其中肺生理学检查22%、CXR检查6%、HRCT检查33%、BAL检查52%、Tc-99 m-DTPA核素扫描15%。根据结果，将其分类为具有临床意义的ILD（第1组）、与ILD相符的异常，但无临床意义的ILD（第2组）和与ILD相符的异常（第3组）。5/36例（14%）在第1组，16/36例（44%）在第2组，15/36例（42%）在第3组。存在与ILD相容的异常的唯一风险因素是男性（p < 0.04，Student t检验）。总之，与早期RA ILD一致的变化很常见。这些变化的意义正在一项纵向研究中确定。
Interstitial lung disease (ILD) is associated with rheumatoid arthritis (RA); however, the prevalence and natural history are undefined. Our aim was to determine the prevalence of ILD associated with RA using a number of sensitive techniques in patients with joint disease of less than 2-yr duration. Patients who met ARA criteria for RA were recruited from community-based and hospital rheumatologists and assessed using the following measures: clinical, lung physiology, radiology (chest X-ray, high resolution CT [HRCT]), bronchoalveolar ravage (BAL) and Tc-99m-DTPA nuclear scan. Thirty-six patients (25 female and 11 male) of joint disease duration of (mean +/- SD) 13.2 +/- 8.6 mo were studied. Abnormalities consistent with ILD were found in one or more investigations in 21 of 36 (58%), which were in lung physiology in 22%, CXR in 6%, HRCT in 33%, BAL in 52%, and Tc-99m-DTPA nuclear scan in 15%. Based on the results, they were categorized as having clinically significant ILD (Group 1), abnormalities compatible with ILD, but no clinically significant ILD (Group 2) and no abnormalities compatible with ILD (Group 3). Five of 36 (14%) were in Group 1, 16 of 36 (44%) in Group 2, and 15 of 36 (42%) in Group 3. The only risk factor for the presence of abnormalities compatible with ILD was male gender (p < 0.04, Student's t test). In conclusion, changes consistent with ILD in early RA are frequent. The significance of these changes is being determined in a longitudinal study.