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Objective: To take advantage of high-resolution CT (high-resolution computed tomography, HRCT) observe the performance of rheumatoid arthritis lung disease, explore these abnormalities and clinical correlation, comparing smoking and not smoking patients, combined with respiratory symptoms and Unconsolidated differences of respiratory symptoms in patients with lung lesions and rheumatoid arthritis lung disease was observed treatment effect for the clinical evaluation of rheumatoid arthritis lung disease Efficacy objective imaging data. Methods: February 2009 - February 2010 Affiliated Hospital of North Sichuan Medical rheumatoid arthritis 98 cases continuous cases, except as history (1) are combined with other lung diseases, such as lung infections, tuberculosis, chronic obstructive pulmonary disease, bronchial asthma, pulmonary heart disease, drug toxicity and lung tumors; (2) other connective tissue disease the merger by clinical or laboratory-confirmed; (3) pneumoconiosis, allergic reaction to inhaled organic matter or tumor radiotherapy-induced interstitial lung disease; (4) chronic cardiac, pulmonary insufficiency, renal insufficiency. All subjects underwent serum laboratory tests, chest X ray radiography and chest HRCT examination. Analysis of each patient's chest radiography and chest HRCT explore the HRCT abnormalities change with patient clinical data, serum laboratory parameters, anti-rheumatic drug therapy situations correlations; same time, the extent of involvement of the lung tissue of patients on HRCT 0 - 4 ratings, analysis of the HRCT lung tissue affected scores and course of the disease, age and smoking index, and compare the smoking and non-smoking patients complicated by respiratory symptoms and the extent of involvement of respiratory symptoms in patients with lung lesions and lung tissue unconsolidated HRCT score Finally, the differences; comparative analysis of the changes in some patients with rheumatoid arthritis before and after treatment in patients with chest HRCT. Results: imaging findings: 98 patients, 61 cases (62.45%) chest radiograph were normal, 11 cases (11.22%), chest X-ray visible interstitial changes, three cases (3.1%) had pleural changes. 56 cases (57.14%) and chest HRCT abnormal changes in reticular opacities (43/98, 43.88%) and interlobular septal thickening (43/98, 43.88%), the most common; 22 cases (22.45%) of visible ground-glass opacities ; 29 cases (29.60%) shows bronchiectasis signs; 17 cases (17.35%) lung tissue visible the subpleural area cellular shadow; 16 cases (16.33%) of visible lung nodules in the lungs or pleura; 22 cases visible pleural involvement (22.45 %); 2 cases (2%) seen the pulmonary trunk significantly enlarged. Abnormal HRCT findings of lung interstitium is mainly distributed in the the double lung base and subpleural regions, and the distribution of the whole lung nodules, emphysema and bronchiectasis was. Clinical data and HRCT findings: age greater than 50 years of age (P = 0.005), IgM rheumatoid factor positive (P lt; 0.0001) and anti-CCP antibody positive (P lt; 0.025) lung disease; chest HRCT The various incidence with previous abnormal changes whether or not to use anti-rheumatoid arthritis drugs with nothing to do. Moderate degree of pulmonary involvement and age was positively correlated (r = 0.683, P lt; 0.0001). No correlation (P = 0.558), the incidence of lung lesions with the duration and the extent of involvement of the lung tissue with no correlation (r = 0.196, P = 0.053). But patients with HRCT abnormalities mainly reticular opacities greater than the average duration of lesions with ground-glass opacities mainly patients (9.05 ± 7.43 vs 5.3 ± 2.21, P = 0.019), the difference was statistically significant (P = 0.019). Comparing smokers with non-smokers lung lesions: 54 cases of smoking in patients with average smoking index was 9.16 ± 7.06 years, 31 cases HRCT scan, abnormal changes; most common anomaly emphysema (31/54, 57.41% ), reticular opacities (22/54, 40.70%) and bronchiectasis (21/54, 38.89%). 44 cases of 25 cases of non-smoking patients with HRCT scan abnormal changes, the most common abnormal changes interlobular septal thickening (24/44, 54.55%), and reticular opacities (21/44, 47.27%). The probability of occurrence of the smoking group emphysema and bronchiectasis higher than non-smoking group. The smoking lung tissue involvement HRCT rated higher than the no-smoking group, but the difference was not statistically significant (vs.2.52 ± 1.00, 2.84 ± 1.04, P = 0.251). Lung tissue involvement HRCT score no correlation with smoking index (r = 0.215, P = 0.122). Combined with respiratory symptoms and patients with respiratory symptoms of chest lesions unconsolidated comparison: 23 combined with respiratory symptoms in 16 patients chest HRCT visible abnormal changes (69.57%); most common HRCT abnormal changes interlobular septal thickening (15/23, 65.22% unconsolidated respiratory symptoms), reticular opacities (14/23, 60.87%) and ground-glass shadow (9/23, 39.13%); 21 group, 9 cases of chest HRCT visible abnormal changes (9/21, 42.86%); The most common manifestations of interlobular septal thickening (9/21, 42.86%) and reticular opacities (7/21, 33.33%); bronchiectasis and honeycombing significant difference in the incidence of difference between the two groups. HRCT lung involvement combined with respiratory symptoms in patients rated higher than the unconsolidated respiratory symptoms group, the difference was statistically significant (3.0 ± 0.85 vs.1.8 ± 0.70, p = 0.002). Rheumatoid arthritis treatment, follow-up CT findings: The study contains a total of 14 patients, follow-up CT scan showed five cases before treatment as the main lesion in patients with ground-glass opacities anti-rheumatic and anti-inflammatory treatment after lesions decrease; no significant change in the scope of the remaining nine cases lesions (n ??= 3) increase (n = 6) or the range. Conclusion: 1 HRCT good observation of lung lesions in rheumatoid arthritis; lesions, interstitial lung disease and airway disease is the most common; most commonly occurs in the the pulmonary the Shimono lung field peripheral zone. 2 of the patient's age and rheumatoid arthritis disease severity associated with rheumatoid arthritis lung disease. Smoking patients with multiple airway involvement, the extent of involvement of elderly patients and consolidated lung tissue of patients with respiratory symptoms are usually more severe, prompted multiple lesions in irreversible fibrosis stage; HRCT in patients with significant respiratory symptoms before detect lung tissue involvement . 3 rheumatoid arthritis HRCT ground glass opacities seen, it is more common in patients with short duration, indicating that the disease in the early phases of activity, and most of them are reversible, so the need for timely treatment.
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