| Object: To investigate the clinical characteristics of RA-ILD patients and the significance of serum KL-6 in RA-ILD.Methods: Retrospective analysis of clinical data of RA patients hospitalized in our hospital during April 2015-January 2017.Patients were divided into RA-ILD group and RA-non ILD group according to chest HRCT results.We also set up health group and pneumonia group control,At the same time health group and pneumonia group control was set up.The level of serum KL-6 was measured by ELISA,compare the the clinical characteristics between the RA-ILD and RA-non-ILD group,compare the difference of serum KL-6 level between each group.Analyzed the correlation between serum KL-6 level and clinical indexes in RA-ILD group.Result: 1.Clinical results of patients with RA-ILD(1)Basic information:A total of 81 patients with RA,22 males and 59 females,aged from 30 to 80 years old.There were 39 patients with RA-ILD,13 males and 26 females,aged from 44 to 80 years old,average(62 ± 7.8)years old,with a duration from 0.2 to 30 years,average(7.66 ± 7.64)years old.(2)Clinical manifestations of RA-ILD patients:Only a small number of patients with respiratory symptoms and mild symptoms.Symptoms of respiratory symptoms in 39 patients included 3 cases(7.7%)with dry cough,2 cases(5.1%)with chest tightness,2 cases with Velcro rales(5.1%)and 1 case with chest pain(2.6%).(3)Imaging of RA-ILD group:(1)The chest HRCT image of RA-ILD patients: Pulmonary lobular septal thickening in 24 cases(61.5%)?23 cases(59%)of fiber?grinding glass density in 19 cases(48.7%)?patch exudation / real shadow in 7 cases(17.9%)?bronchial stretch in 7 cases(17.9%)?grids 6 cases(15.4%)?2 cases of honeycomb shadow(5.1%),1 case of inferior pleural radiography(2.6%).(2)RA-ILD group image classification results: UIP type 7 cases(17.95%),NSIP type 13 cases(33.33%),unclassified 19 cases(48.72%)(3)RA-ILD group imaging results: I grade 37 cases(94.9%),II grade 2 cases(5.1%)2.Results of RA-ILD compared with RA-non-ILD group(1)Comparison of the basic clinical situation: RA-ILD group was higher than the RA-non-ILD group(P <0.05)(2)Comparison of laboratory indicators:There was no significant difference in WBC,LDH,ESR,CRP,immunoglobulin,complement,RF titer and anti-CCP level between the two groups(P> 0.05)(3)tumor markers: RA-ILD group of patients with CA19-9 levels higher than RA-non-ILD group(P <0.05)(4)Serum KL-6 Comparison Results: The level of serum KL-6(U / ml)in RA-ILD group was(269.72 ± 210.24),higher than that in RA-non-ILD group(76.93 ± 80.32)and healthy control group(99.23 ± 35.80),And the difference was statistically significant(P <0.05).3.The correlation between serum KL-6 level and clinical index in patients with RA-ILD group(1)The basic clinical situation: serum KL-6 and age,age of onset,duration,joint swelling and tenderness were not correlated(P> 0.05)(2)Laboratory indicators: serum KL-6 levels and LDH was positively correlated(r = 0.756,P <0.05),and PLT,complement C3 was negatively correlated(r were-0.342,-0.497,P <0.05).(3)Tumor markers: Serum KL-6 levels were positively correlated with Fer(r = 0.629,P <0.01)Conclusion: 1.RA-ILD patients with respiratory system atypical,symptomatic occlusion,need to improve the chest early HRCT examination.2.Age,CA19-9 increased and the occurrence of RA-ILD is closely related.3.Serum KL-6 level can be used as one of the serological indicators of RA-ILD diagnosis... |
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