Arthritis Rheumatol:类风湿性关节炎与肺功能指标的关系

2021-11-19 xiangting MedSci原创

RA与肺通气限制性和阻塞性的几率升高相关,这种关联不能用混杂因素解释。

类风湿关节炎是一种累及全身的自身免疫性疾病,其中肺部受损害很常见,约30%-50%的类风湿关节炎患者可有肺部表现。这项研究探讨了与一般人群相比,类风湿性关节炎 (RA) 对肺通气类型和严重程度的独立影响。

这项横断面研究调查了英国生物银行受试者中 RA 与肺功能测量指标之间的关联。根据自我报告和目前使用疾病改善抗风湿药/糖皮质激素确定RA患者。对照组是来自一般人群的非RA受试者。肺功能测量指标包括1秒用力呼气量占预测值百分比 (FEV1 %) 和用力肺活量占预测值百分比 (FVC%)、通气类型(限制性或阻塞性)以及限制性或阻塞性的严重程度。使用多因素回归估算RA 病例的影响,调整了年龄、性别、体重指数和吸烟状况。

在350,776 名接受肺活量测定的受试者中(平均年龄 56.3 岁;55.8% 为女性;45.5%曾经吸烟),确定了 2,008 例 RA患者。在多因素分析中,与对照组相比,RA 与FEV1% (β=–2.93 [95%CI–3.63, –2.24])、FVC% (β=–2.08 [95% CI –2.72, – 1.45]) 和 FEV1/FVC 下降相关(β=–0.008 [95%CI–0.010, –0.005])。RA 还与限制性类型(比值比 [OR] 1.36 [95% CI 1.21, 1.52])和阻塞性(OR 1.21 [95% CI 1.07, 1.37])相关,与混杂因素无关,并且与严重阻塞和限制的相关性最强。

                                          RA的肺功能测量指标

由此可见,RA与肺通气限制性和阻塞性的几率升高相关,这种关联不能用混杂因素解释。除了限制性肺部疾病,临床医生还应该意识到气道阻塞也可能是 RA 的肺部表现。

 

原始出处:

Lauren Prisco. Relationship Between Rheumatoid Arthritis and Pulmonary Function Measures on Spirometry in the UK Biobank. Arthritis Rheumatol. November 2021.

 

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