Prognostic Factors of the RA Patients with ILD

OBJECTIVE: Interstitial lung disease (ILD) is a common pulmonary manifestation of rheumatoid arthritis (RA), and an important cause of morbidity and mortality in RA. We compared demographic and clinical characteristics of usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP) patterns in RA patients and determined the prognostic factors that influence the survival of RA-ILD patients. METHODS: 51 enrolled RA patients (male n=21, female n=30) with ILD underwent HRCT. We categorized ILD into two groups, as the UIP pattern and the NSIP pattern, using HRCT. HRCT scans were scored to investigate the extent of the ILD. We divided the extent of the interstitial lung disease into 4 groups 1~14%, 15~19%, 20~24%, >25%. RESULTS: There were no significant differences between the UIP and NSIP pattern in the clinical characteristics, except for age at the time of the study (RA-NSIP pattern vs RA-UIP pattern 62.3+/-11.7 vs 68.2+/-8.4, p=0.042). There were no significant differences in survival time between the RA-UIP and RA-NSIP pattern (Log rank p=0.985). The extent of ILD on chest HRCT was significantly associated with mortality (HR=1.044, 95% CI 1.019~1.069) and patients that were diagnosed with ILD at an older age (HR=1.109, 95% CI 1.024~1.200) were associated with a worse prognosis. Comparing four groups divided by the extent of the lung disease, there were significant differences in survival estimates (Log-rank p-value<0.001) based on an ILD extent of 15%. CONCLUSION: Our study reveals that the extent of ILD on chest HRCT was found to be significantly associated with poor prognosis of RA-ILD patients.

Prognostic Factors of the RA Patients with ILD

OBJECTIVE: Interstitial lung disease (ILD) is a common pulmonary manifestation of rheumatoid arthritis (RA), and an important cause of morbidity and mortality in RA. We compared demographic and clinical characteristics of usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP) patterns in RA patients and determined the prognostic factors that influence the survival of RA-ILD patients. METHODS: 51 enrolled RA patients (male n=21, female n=30) with ILD underwent HRCT. We categorized ILD into two groups, as the UIP pattern and the NSIP pattern, using HRCT. HRCT scans were scored to investigate the extent of the ILD. We divided the extent of the interstitial lung disease into 4 groups 1~14%, 15~19%, 20~24%, >25%. RESULTS: There were no significant differences between the UIP and NSIP pattern in the clinical characteristics, except for age at the time of the study (RA-NSIP pattern vs RA-UIP pattern 62.3+/-11.7 vs 68.2+/-8.4, p=0.042). There were no significant differences in survival time between the RA-UIP and RA-NSIP pattern (Log rank p=0.985). The extent of ILD on chest HRCT was significantly associated with mortality (HR=1.044, 95% CI 1.019~1.069) and patients that were diagnosed with ILD at an older age (HR=1.109, 95% CI 1.024~1.200) were associated with a worse prognosis. Comparing four groups divided by the extent of the lung disease, there were significant differences in survival estimates (Log-rank p-value<0.001) based on an ILD extent of 15%. CONCLUSION: Our study reveals that the extent of ILD on chest HRCT was found to be significantly associated with poor prognosis of RA-ILD patients.

Trends and predictors of changes in pulmonary function after treatment for pulmonary tuberculosis

OBJECTIVES: The present study aimed to investigate the trends in changes in pulmonary function and the risk factors for pulmonary function deterioration in patients with pulmonary tuberculosis after completing treatment. INTRODUCTION: Patients usually have pulmonary function abnormalities after completing treatment for pulmonary tuberculosis. The time course for changes in pulmonary function and the risk factors for deterioration have not been well studied. METHODS: A total of 115 patients with 162 pulmonary function results were analyzed. We retrieved demographic and clinical data, radiographic scores, bacteriological data, and pulmonary function data. A generalized additive model with a locally weighted scatterplot smoothing technique was used to evaluate the trends in changes in pulmonary function. A generalized estimating equation model was used to determine the risk factors associated with deterioration of pulmonary function. RESULTS: The median interval between the end of anti-tuberculosis treatment and the pulmonary function test was 16 months (range: 0 to 112 months). The nadir of pulmonary function occurred approximately 18 months after the completion of the treatment. The risk factors associated with pulmonary function deterioration included smear-positive disease, extensive pulmonary involvement prior to anti-tuberculosis treatment, prolonged anti-tuberculosis treatment, and reduced radiographic improvement after treatment. CONCLUSIONS: After the completion of anti-tuberculosis TB treatment, several risk factors predicted pulmonary function deterioration. For patients with significant respiratory symptoms and multiple risk factors, the pulmonary function test should be followed up to monitor the progression of functional impairment, especially within the first 18 months after the completion of anti-tuberculosis treatment.

Relationship of involvement area with clinical, endoscopic and pathological characteristics of ulcerative colitis / 第二军医大学学报

Objective: To investigate the relationship of involvement area with the clinical, endoscopic and pathological characteristics of ulcerative colitis (UC). Methods: We retrospectively studied the clinical, endoscopic and pathological data of 75 patients with UC, including 17(22.67%) with distal colitis,27(36%) with left-sided colitis and 31(41.33%) with extensive colitis/pancolitis. Results: No differences were found in the gender and age of onset between different groups. The incidences of main clinical manifestations and complications increased with the increase of the UC involvement, with significant difference found in the incidences of anemia, hypoproteinemia and extraintestinal manifestations between different groups (P<0.05). Positive correlation was found between the UC involvement with the UC severity (r=0.418, P<0.001) and disease activity under endoscopy (r=0.239, P=0.039). The incidence of atypical hyperplasia of enteric epithelium in extensive colitis/pancolitis group was significantly higher than those in the other 2 groups (both P<0.05). Conclusion: The UC involvement is related to the clinical, endoscopic and pathological characteristics of UC; the involvement is positively correlated with the clinical severity and disease activity of UC under coloscopy.