Impact of interstitial lung disease on mortality of patients with rheumatoid arthritis
Impact of interstitial lung disease on mortality of patients with rheumatoid arthritis
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DOI：
10.1007/s00296-017-3781-7
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发表时间：
2017-10-01
影响因子：
4
通讯作者：
Sung, Yoon-Kyoung
中科院分区：
文献类型：
--
作者：
Kim, Dam;Cho, Soo-Kyung;Sung, Yoon-Kyoung
旨在确定韩国类风湿关节炎 (RA) 患者间质性肺疾病 (ILD) 的患病率并评估其对死亡率的影响。共有 3555 名 RA 患者在入组时有胸部 X 光或胸部计算机断层扫描 (CT) 数据，这些患者是从韩国关节炎观察研究网络队列中提取的，这是一个针对韩国 RA 患者的全国性前瞻性队列。将患者分为两组：(1) 通过胸部 X 光或胸部 CT 扫描进行 ILD 组，以及 (2) 通过这些方式进行非 ILD 组。在比较入组时各组的特征后，使用对数秩检验比较死亡率。为了探讨 ILD 对死亡率的影响，使用了 Cox 比例风险模型。 64 名患者 (1.8%) 被确定患有 ILD。 ILD 组中男性和老年患者更为常见。在平均 24 个月的随访期间，ILD 组有 6 名患者（9.4%）死亡，非 ILD 组有 25 名患者（0.7%）死亡； ILD 组的生存率明显较差 (p < 0.01)。经过调整分析，ILD 与死亡率增加显着相关（HR 7.89，CI 3.16-19.69，p < 0.01）； ILD 患者的死亡风险甚至高于心血管疾病患者（CVD，HR 4.10，CI 1.79-9.37，p < 0.01）。韩国 RA 患者 ILD 患病率为 1.8%。 ILD 是 RA 患者死亡的主要危险因素。
To identify the prevalence of interstitial lung disease (ILD) in Korean patients with rheumatoid arthritis (RA) and assess its effect on mortality. A total of 3555 patients with RA, with chest X-ray or chest computed tomography (CT) data at enrollment were extracted from the KORean Observational study Network for Arthritis cohort, a nationwide prospective cohort for patients with RA in Korea. The patients were classified into two groups: (1) an ILD group by chest X-ray or chest CT scan, and (2) a non-ILD group by these modalities. After comparing the characteristics of the groups at enrollment, mortalities were compared using the log-rank test. To explore the impact of ILD on mortality, Cox proportional hazard models were used. Sixty-four patients (1.8%) were identified with ILD. Male and older patients were more common in the ILD group. During a mean follow-up of 24 months, 6 patients (9.4%) in the ILD group and 25 patients (0.7%) in the non-ILD group died; the survival rate was significantly worse in the ILD group (p < 0.01). On adjusted analysis, ILD was significantly associated with increased mortality (HR 7.89, CI 3.16-19.69, p < 0.01); the risk of death in patients with ILD was even higher than in patients with cardiovascular disease (CVD, HR 4.10, CI 1.79-9.37, p < 0.01). The prevalence of ILD was 1.8% in Korean patients with RA. ILD is a major risk factor for mortality in patients with RA.