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合并类风湿关节炎对支气管扩张症的影响及相关因素研究
丁薇
赵云峰
陆海雯
梁硕
程克斌
徐金富
作者及单位信息
·
DOI： 10.3760/cma.j.issn.1001-0939.2017.01.006
Study on the effect and predictive to bronchiectasis combined with rheumatoid arthritis
Ding Wei
Zhao Yunfeng
Lu Haiwen
Liang Shuo
Cheng Kebin
Xu Jinfu
Authors Info & Affiliations
Ding Wei
Department of Respiratory and Critical Care Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai 200433, China
Zhao Yunfeng
Lu Haiwen
Liang Shuo
Cheng Kebin
Xu Jinfu
·
DOI： 10.3760/cma.j.issn.1001-0939.2017.01.006
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摘要

目的探讨合并类风湿关节炎对支气管扩张症(支扩症)的影响及相关因素。

方法回顾性分析上海市肺科医院呼吸科和上海市浦东新区公利医院呼吸科2012年1月至2015年12月住院的支扩症患者148例，男74例，女74例，年龄45～79岁，平均(65±11)岁。其中合并类风湿关节炎(合并症组)70例，男34例，女36例，年龄45～79岁，平均(68±12)岁。单纯支扩症(单纯支扩组)78例，男40例，女38例，年龄49～76岁，平均(63±10)岁。比较两组患者的临床特征、血清抗环瓜氨酸肽抗体(抗CCP抗体)、类风湿因子、胸部高分辨率CT、肺功能及支扩症严重程度评分(FACED评分)，分析两组患者血清抗CCP抗体与FACED评分的相关性。

结果合并症组血清抗CCP抗体浓度为(196±68) U/ml，FACED评分为(5.2±1.8)分，明显高于单纯组的(64±26) U/ml和(3.1±1.4)分，两组比较差异均有统计学意义( P值分别为0.032和0.044，均 P<0.05)；两组血清抗CCP抗体浓度与FACED评分均呈正相关( r值分别为0.678和0.461, P<0.05)。

结论与单纯支扩症相比，合并类风湿关节炎的支扩症病情更严重。抗CCP抗体浓度明显升高对该病的诊断及预后有一定的预测价值。

支气管扩张症;关节炎，类风湿
ABSTRACT

ObjectiveTo explore the clinical characteristics of bronchiectasis(BR)coexisting in patients with rheumatoid arthritis (RA).

MethodsOne hundred and forty-eight bronchiectasis patients were retrospectively analyzed. These cases were all diagnosed in the Respiratory Department of Shanghai Pulmonary Hospital and Shanghai Gongli Hospital of Pudong New Area during Jan. 2012 to Dec.2015.The patients consisted of 74 males and 74 females, aging from 45 to 79 [mean(65±11)] years. In these patients, coexisting rheumatoid arthritis was found in 34 males and 36 females, aging from 45 to 79[mean(68±12)] years(RA-BR group). Patients with bronchiectasis alone consisted of 40 males and 38 females, aging from 49 to 76 [mean(63±10)] years (BR alone group). Data between the 2 groups of patients were compared, including general clinical features, serum anti-cyclic citrullinated peptide antibodies (anti-CCP), rheumatoid factor (RF), chest high-resolution CT (HRCT), and lung function . FACED scores were used to assess the severity of bronchiectasis. Meanwhile, we analyzed the correlation between anti-CCP and FACED scores in the 2 groups.

ResultsWe observed an increase of serum anti-CCP in RA-BR patients compared with BR alone patients (196±68 versus 64±26, P<0.05). In addition, FACED scores in RA-BR patients were higher than those in BR patients (5.2±1.8 versus 3.1±1.4 , P< 0.05). Positive correlations between serum anti-CCP levels and FACED scores ( r=0.678, r=0.461, P<0.05) in both RA-BR and BR alone groups were observed in this study.

ConclusionsThe disease severity scores of RA-BR patients were higher than those of patients with BR alone. Levels of serum anti-CCP may act as a predictor for the diagnosis and prognosis of bronchiectasis in patients with RA.

Bronchiectasis;Arthritis, rheumatoid
Xu Jinfu, Email: mocdef.labiamgncuxfj
Project Supported by the National Natural Science Foundation of China(81370109); The Elite Program of Shanghai Education Commission(13SG21)
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引用本文

丁薇,赵云峰,陆海雯,等. 合并类风湿关节炎对支气管扩张症的影响及相关因素研究[J]. 中华结核和呼吸杂志,2017,40(1)：24-28.

DOI:10.3760/cma.j.issn.1001-0939.2017.01.006

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支气管扩张症(支扩症)是多种原因引起的支气管壁结构破坏，支气管树的病理性、永久性扩张，导致反复发生化脓性感染的气道慢性炎症 [ 1 ]。迄今为止，70%以上的患者病因不明，考虑可能与既往呼吸道感染、免疫功能缺陷及自身免疫性疾病等相关 [ 2 ]。类风湿关节炎(类风关)是以侵蚀性关节炎为主要表现的全身性自身免疫性疾病 [ 3 ]，其发病机制与环境(吸烟、感染等)及遗传因素有关，累及肺部可引起肺间质纤维化、肺内类风湿结节、胸膜炎及支气管扩张等。支扩症与类风关两种疾病的发病机制及因果关系一直是国内外学者研究的热点。本研究主要针对合并类风关的支扩症患者与同期住院的单纯支扩症患者的病情严重度进行对比，观察与支扩症病情严重度相关的危险因素，探讨支扩症与类风关发病机制的相关性。
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备注信息
A
徐金富，Email： mocdef.labiamgncuxfj
B
国家自然科学基金 (81370109)
上海市教委曙光计划 (13SG21)
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