本文選題：類風濕關節(jié)炎 + 肺間質(zhì)病變�。� 參考：《重慶醫(yī)科大學》2017年碩士論文

【摘要】：目的:探討抗環(huán)瓜氨酸肽抗體(抗CCP抗體)與類風濕關節(jié)炎合并肺間質(zhì)病變(RA-ILD)的相關性。方法:選取重慶醫(yī)科大學附屬第一醫(yī)院中西醫(yī)結合科2013年5月—2016年2月住院收治的241例RA患者臨床資料,其中男性55例,女性186例,平均年齡56歲。依據(jù)胸部X片和(或)高分辨率CT檢查結果分為兩組:合并肺間質(zhì)病變組(RA-ILD組)65例(26.97%),單純RA組176例(73.03%)。通過t檢驗及χ~2檢驗進行單因素分析,將有意義的變量納入多因素Logistic回歸分析。結果:單因素分析表明,抗CCP抗體滴度(226.46±132.20 vs148.51±73.96 u/ml,t值=-2.81,P=0.005)、年齡(63.26±12.11 vs53.47±13.56/歲,t值=-5.39,P=0.000)、吸煙史(20%vs13.07%,χ~2值=6.92,P=0.009)、受累關節(jié)數(shù)(13.4±5.04 vs 11.6±5.61/個,t值=-2.34,P=0.021)、病程長短(105.22±104.19 vs 69.71±94.13/月,t值=-2.52,P=0.012)對RA合并ILD有統(tǒng)計學意義(P0.05)。兩組患者性別分布、血沉(ESR)、類風濕因子(RF)、C-反應蛋白(CRP)、血小板(PLT)、C3、C4、Ig A、Ig G差異無統(tǒng)計學意義(P0.05)。多因素分析結果表明,抗CCP抗體(χ~2=4.509,OR=1.002,P值=0.034)、年齡(χ~2=16.203,OR=1.058,P值=0.000)是RA患者合并ILD的獨立危險因素。分層檢驗提示RA-ILD組抗CCP抗體高滴度(≥300 u/ml)患者所占的百分比明顯高于單純RA組(35.38%vs 20.44%,P=0.017)。結論:年齡、抗CCP抗體可能與RA患者合并肺間質(zhì)病變密切相關,故對高齡、高滴度抗CCP抗體的RA患者應早期行HRCT檢查,以早期診斷和治療。
[Abstract]:Objective: to investigate the correlation between anti-cyclic citrullin-peptide antibody (anti-CCP) and RA- ILD in rheumatoid arthritis complicated with pulmonary interstitial disease. Methods: 241 RA patients, 55 males and 186 females, with an average age of 56 years, were selected from the Department of Integrated Chinese Medicine and Western Medicine of the first affiliated Hospital of Chongqing Medical University from May 2013 to February 2016. According to the results of chest X ray and / or high resolution CT, the patients were divided into two groups: 65 patients with RA-ILD complicated with pulmonary interstitial disease and 176 patients with RA. Through t test and 蠂 2 test univariate analysis was carried out, and the significant variables were included in multivariate logistic regression analysis. 緇撴灉:鍗曞洜绱犲垎鏋愯〃鏄，

本文編號：2016291