摘要
目的研究老年类风湿关节炎(PA)患者肺功能变化及与其他指标的相关性。方法将66例RA患者按年龄分为中青年类风湿关节炎(YMRA)、老年类风湿关节炎(ERA)两组,采用肺功能仪检测两组RA患者的肺功能变化,并与健康对照组(NC)进行比较;观察两组RA患者的生活质量、焦虑(SAS)和抑郁(SDS)、社会支持评定(SSRS)量表、健康指数(HAQ)、疾病活动度评分(DAS-28)及临床症状、体征及实验室指标的变化。结果(1)在66例RA患者中,YMRA占71.2%,ERA占28.8%;与健康对照组比较可知,RA患者肺功能异常率最高的为FEF75(66.7%),其次为FEF50、MVV、FEF25;ERA组FEF75异常率达74.4%,PEF、MVV异常率分别为73.4%、57.9%。(2)与NC组比较,YMRA组、ERA组VC、FEV1、FVC、MVV、FEF25、FEF50、FEF75、PEF明显降低(P<0.01)。与YMRA组相比,ERA组SSRS、双手握力数、ASO、CD4+CD25+CD127-Treg降低(P<0.05);生理功能积分、社会功能积分、心理功能积分、健康认识积分、生活质量总积分、SAS、SDS、HAQ、关节肿胀、关节压痛、中医症候总积分、血清铁、X胸片分级显著升高(P<0.05或P<0.01)。(3)Spearman相关分析结果显示,ERA组患者肺功能参数FEV1与晨僵呈正相关,FEF25与关节压痛呈正相关(P<0.05);VC、FVC与15 m步行时间呈负相关,FEV1、PEF与关节压痛呈负相关,MVV与DAS-28呈负相关,FEF50与关节压痛、15 m步行时间呈负相关,FEF75与补体C3呈负相关(P<0.05或P<0.01)。结论类风湿关节炎患者随着年龄的增长,其肺功能水平显著下降,表现为小气道功能的严重损伤,并伴有混合性通气功能障碍。
Objective To study the pulmonary function changes in the elderly patients with rheumatoid arthritis and their correlation. Methods 66 patients with rheumatoid arthritis （RA） patients were divided into young and middle-aged patients with rheumatoid arthritis （ YMRA ）, elderly-onset rheumatoid arthritis （ ERA ） two groups, using two sets of pulmonary function detected by changes in lung function in patients with RA, and compared with normal control group;observe the quality of life of two groups of patients with RA, anxiety（SAS） and depression（ SDS）, Social Support Rating （SSRS） scale, health index （ HAQ ）, disease activity score （ DAS-28 ） and clinical symptoms, signs and laboratory indicators of change. Results 1. Among the 66 cases, YMRA accounted for 71.2%, ERA 28.8%. Compared with the normal control group, RA patients with the highest rate of lung function abnormalities for FEF75 （66.7 % ） , followed by FEF50, MVV and FEF25. In ERA group the difference rate of FEF75 was up to 74.4% , and PEF, MVV abnormal rates were 73.4% and 57.9%, respectively. 2. Compared with NC group, YMRA group and ERA group had significantly lower VC, FEV1, FVC, MVV, FEF25, FEF50, FEF75 and PEF （ P 〈 0.01 ）. Compared with the YMRA group, ERA group SSRS, the number of pairs of grip strength, ASO, CD4^＋ CD25 ^＋ CD127 - Treg reduction （ P 〈 0.05 ）, physiological functions of integration, social function score, mental function score, health, knowledge integration, quality of life total score, SAS, SDS, HAQ ,joint swelling,joint tenderness, Chinese medicine symptom total score, serum iron,x chest X-ray grade was significantly higher（ P 〈 O. 05 or P 〈 0. Ol ）. 3. Spearman correlation analysis showed that, ERA group of patients with pulmonary function parameters of FEV1 and morning stiffness were positively correlated, FEF25 and joint tenderness were positively correlated （ P 〈 0.05 ）. VC, FVC and 15m walking time was neg- atively correlated, FEV1, PEF and joint tenderness a negative correlation, MVV with the DAS-28 was negatively corre- lated,FEF50 and joint tenderness, 15m walking time was negatively correlated, FEF75 and complement C3 was negatively correlated（ P 〈 0. 05 or P 〈 0.01 ）. Conclusion The lung function decreased significantly in patients with rheumatoid arthritis with age increasing, and presented the serious injury of small airway function and dysfunction associated with mixed ventilation（ restrictive and obstructive ventilatory dysfunction）.
出处
《中国临床保健杂志》
CAS
2010年第1期4-8,共5页
Chinese Journal of Clinical Healthcare
基金
国家中医药管理局科研课题专项基金(04-05LP27)
安徽省十一五攻关项目(07010300204)
安徽科技重点研究项目(06023068)
安徽现代中医内科应用基础与开发研究省级实验室建设项目(科条[2008]150号)
安徽省教育厅自然科学重点科研项目(KJ2008A165)
关键词
关节炎
类风湿
肺通气
肺活量
危险因素
Arthritis, Rheumatoid
Pulmonary ventilation
Vital capacity
Risk factors
