Acute exacerbation in rheumatoid arthritis-associated interstitial lung disease: a retrospective case control study.
Acute exacerbation in rheumatoid arthritis-associated interstitial lung disease: a retrospective case control study.
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DOI：
10.1136/bmjopen-2013-003132
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发表时间：
2013-09-13
期刊：
影响因子：
2.9
通讯作者：
Chida K
中科院分区：
文献类型：
--
作者：
Hozumi H;Nakamura Y;Johkoh T;Sumikawa H;Colby TV;Kono M;Hashimoto D;Enomoto N;Fujisawa T;Inui N;Suda T;Chida K
目的：探讨类风湿关节炎相关性间质性肺疾病（RA-ILD）患者急性加重（AE）的相关危险因素及预后。回顾性病例对照研究。一个单一的学术医院。1995年至2012年间，51例连续诊断为RA-ILD的患者。所有患者均符合美国风湿病学会对RA的诊断标准。ILD的诊断是基于临床表现、肺功能检查、高分辨率CT （HRCT）表现和肺活检结果。采用Kaplan-Meier法分析总生存期和累积AE发生率。Cox风险分析用于确定与AE发生和生存状态相关的重要变量。共有11例患者（22%）发生AE， 1年总发病率为2.8%。单因素分析显示，ILD诊断时年龄较大（HR 1.11; 95% CI 1.02 ~ 1.21; p=0.01）、HRCT上常见间质性肺炎（UIP）模式（HR 1.95; 95% CI 1.07 ~ 3.63; p=0.03）和甲氨蝶呤使用（HR 3.04; 95% CI 1.62 ~ 6.02; p=0.001）与AE相关。观察期间发生AE的11例患者中，有7例（64%）死于初始AE。在生存率方面，AE是预后不良的预后因素（HR 2.47; 95% CI 1.39 ~ 4.56; p=0.003）。在RA-ILD患者中，ILD诊断时年龄较大，HRCT上的UIP模式和甲氨蝶呤的使用与AE的发生有关。AE严重影响患者的生存。
To investigate the risk factors and prognosis associated with acute exacerbation (AE) in patients with rheumatoid arthritis-associated interstitial lung disease (RA-ILD). A retrospective case–control study. A single academic hospital. 51 consecutive patients diagnosed with RA-ILD between 1995 and 2012. All patients fulfilled the diagnostic criteria of the American College of Rheumatology for RA. ILD was diagnosed on the basis of clinical presentation, pulmonary function tests, high-resolution CT (HRCT) findings and lung biopsy findings. Overall survival and cumulative AE incidence were analysed using Kaplan-Meier method. Cox hazards analysis was used to determine significant variables associated with AE occurrence and survival status. A total of 11 patients (22%) developed AE, with an overall 1-year incidence of 2.8%. Univariate analysis revealed that older age at ILD diagnosis (HR 1.11; 95% CI 1.02 to 1.21; p=0.01), usual interstitial pneumonia (UIP) pattern on HRCT (HR 1.95; 95% CI 1.07 to 3.63; p=0.03) and methotrexate usage (HR 3.04; 95% CI 1.62 to 6.02; p=0.001) were associated with AE. Of 11 patients who developed AE during observation period, 7 (64%) died of initial AE. In survival, AE was a prognostic factor for poor outcome (HR 2.47; 95% CI 1.39 to 4.56; p=0.003). In patients with RA-ILD, older age at ILD diagnosis, UIP pattern on HRCT and methotrexate usage are associated with the development of AE. Furthermore, AE has a serious impact on their survival.
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影响因子：
4
作者：
Yoshinouchi, T;Ohtsuki, Y;Ueda, R
通讯作者：
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