Related factors, increased mortality and causes of death in patients with rheumatoid arthritis-associated interstitial lung disease
Related factors, increased mortality and causes of death in patients with rheumatoid arthritis-associated interstitial lung disease
复制标题
DOI：
10.1080/14397595.2019.1621462
复制
发表时间：
2019-06-07
影响因子：
2.2
通讯作者：
Matsui, Toshihiro
中科院分区：
文献类型：
--
作者：
Kakutani, Takuya;Hashimoto, Atsushi;Matsui, Toshihiro
目的：间质性肺病（ILD）是类风湿关节炎（RA）的一种危及生命的关节外表现。我们的目的是阐明RA患者中伴有普通型间质性肺炎（UIP）或非UIP的慢性ILD与死亡率之间的关系。方法：回顾性调查2009年至2014年在我院就诊的连续RA患者的信息。通过高分辨率计算机断层扫描检查其死亡率与慢性ILD（UIP或非UIP）之间的关系。结果：在2702例患者中，261例（9.7%）患有慢性ILD，其中120例具有UIP模式。在RA发病时，慢性ILD的患病率为6%。患有慢性ILD的患者的死亡率高于没有患有慢性ILD的患者。最常见的死亡原因是肺炎，包括慢性ILD的急性加重（AE）。与其他死亡者相比，在具有UIP模式的慢性ILD死亡患者中经常发现肺癌死亡（p= 0.062）。具有UIP模式的慢性ILD患者的肺癌估计死亡率比一般人群高5倍。结论：类风湿性关节炎合并间质性肺疾病患者具有UIP模式，死亡率高，易死于AE或肺癌。
Objectives: Interstitial lung disease (ILD) is a life-threatening extra-articular manifestation of rheumatoid arthritis (RA). We aimed to clarify the relationship between chronic ILD with a pattern of usual interstitial pneumonia (UIP) or non-UIP and mortality in RA patients. Methods: We retrospectively surveyed information of consecutive RA patients who visited our hospital from 2009 to 2014. The relationship between their mortality and chronic ILD (UIP or non-UIP) detected by high-resolution computed tomography was examined. Results: Of 2702 patients enrolled, 261 (9.7%) had chronic ILD and among these 120 had a UIP pattern. At the onset of RA, the prevalence of chronic ILD was 6%. Patients with chronic ILD had a higher mortality than those without. The most frequent cause of death was pneumonia including acute exacerbation (AE) of chronic ILD. Lung cancer death was frequently identified in deceased patients with chronic ILD with a UIP pattern compared with the other decedents (p=.062). The estimated mortality of lung cancer in patients with chronic ILD with a UIP pattern was five times higher than the general population. Conclusion: RA patients with ILD with a UIP pattern have a high mortality rate and are prone to die of AE or lung cancer.