来源：风湿病与关节炎,2018,7（4）:5-10,15.

类风湿关节炎呼吸系统共病的初步研究（临床研究）

牛雪敏^1,2，李振彬¹，刁玉晓^1,3，董　琪^1,2，刘　旭^1,2，张旭飞^1,3，张明明¹

　　【摘　要】目的：探讨类风湿关节炎（RA）患者呼吸系统共病（共存疾病）的临床特点及相关危险因素。方法：根据ICD-10编码的电子病历首页出院诊断，统计151例住院RA患者慢性呼吸系统疾病的构成比；将RA患者分为RA呼吸系统共病（RA-RC）组和RA无呼吸系统共病（RA-NRC）组，比较一般临床资料、RA活动度、自身抗体、血液学及生化指标等在2组患者间的差异；分析其他非呼吸系统共病在2组患者的分布及其对RA-RC的影响；Logistic回归分析RA-RC的相关危险因素。结果：151例RA患者中RA-RC患者62例（41.06%），其中以间质性肺疾病最多（50.00%），其次为支气管扩张症（17.74%）、慢性支气管炎（17.74%）、肺气肿（8.06%）、慢性阻塞性肺疾病（6.45%）。与RA-NRC组比较，RA-RC组患者年龄较大、吸烟率高、病程更长、类风湿因子（RF）水平更高（P < 0.05）。Logistic回归分析显示，年龄、吸烟是RA-RC的危险因素。RA-RC组非呼吸系统共病的发病率为96.77%，显著高于RA-NRC组（77.53%），差异有统计学意义（P < 0.05）；2组间非呼吸系统共病的种类也存在一定差别。结论：RA-RC患病率高，年龄与吸烟可能是其危险因素；共存非呼吸系统共病也可能对RA-RC的发生具有影响。

　　【关键词】　关节炎，类风湿；共病；呼吸系统；回顾性研究

A Preliminary Study on the Comorbidity of Respiratory System in Rheumatoid Arthritis

NIU Xue-min,LI Zhen-bin,DIAO Yu-xiao,DONG Qi,LIU Xu,ZHANG Xu-fei,ZHANG Ming-ming

　　【ABSTRACT】Objective:To investigate the clinical features and related risk factors of respiratory comorbidities（coexisting diseases）in patients with rheumatoid arthritis（RA）.Methods:Based on the ICD-10-encoded electronic medical record first page discharge diagnosis,the composition ratio of chronic respiratory diseases in 151 RA patients was counted;RA patients were divided into RA respiratory comorbidity （RA-RC）group and RA non-respiratory system comorbidity（RA-NRC）group,the differences in general clinical data,RA activity,autoantibodies,hematology,and biochemical indices between the two groups of patients;the distribution of other non-respiratory comorbidities in the two groups of patients and their comparison RA-RC effects;Logistic regression analysis of RA-RC related risk factors.Results:Of the 151 patients with RA,62（41.06%）had RA-RC,with interstitial lung disease being the most common（50.00%）,followed by bronchiectasis（17.74%）,chronic bronchitis（17.74%）,and lungs.Emphysema（8.06%）,chronic obstructive pulmonary disease（6.45%）.Compared with RA-NRC group,patients in RA-RC group had older age,higher smoking rate,longer duration,and higher level of rheumatoid factor（RF）（P < 0.05）.Logistic regression analysis showed that age and smoking were risk factors for RA-RC.The incidence of non-respiratory comorbidity in RA-RC patients was 96.77%,which was significantly higher than that in RA-NRC group（77.53%）（P < 0.05）.There were also non-respiratory comorbidities between the two groups.Conclusion:The prevalence of RA-RC is high,age and smoking may be risk factors;coexistence of non-respiratory comorbidities may also have an impact on the occurrence of RA-RC.

　　【Keywords】 arthritis,rheumatoid;comorbidity;respiratory;retrospective study