The Relationship Between Serological Markers Of Rheumatoid Arthritis Complicated With Interstitial Lung Disease And Sputum Type

Research BackgroundRheumatoid Arthritis(RA)is an autoimmune disease that can involve multi-system,such as respiratory system.The main symptoms have peripheral arthritis,especially small joints.During the disease course,joints may be destroyed and distorted.Rheumatoid arthritis-interstitial lung disease(RA-ILD)have a high morbidity,and in the early stage being easily ignored because of the symptoms and signs not obvious,which later can be irreversible pulmonary fibrosis.At present,the serological indicators of ILD involve anticyclic citrullinated peptide antibody(ACCP),anti-keratin antibody(AKA),complement(C)and so on.There are little research about the relation between AKA,C and RA-ILD.Some researchers think that there may be a correlation between the above indicators and RA-ILD.But other researchers have found no correlation between the two.In the field of traditional Chinese medicine,study of RA-ILD mostly involved in the disease syndrome differentiation of TCM and disease treatment experience,or involved in herbal pharmacology and integrative medicine therapy,etc.IN syndrome differentiati on of TCM,few Chinese studies research whether there is any difference between the serological indicators of RA-ILD and Rheumatoid arthritis-none Interstitial lung disease.ObjectiveTo study serological indicators of RA-ILD and RA patients,such as CCP,AKA,C and TCM syndrome types.Through the statistics method,this trial studies whether there is serological indicators difference between RA-ILD and RA groups,and whether there is any difference between the serological indicators of different syndrome types in the two groups,in order to provide reference significance for clinic.MethodsFrom the January I,2011 to October 31,2016,at TCM Department of rheumatism,547 patients with RA-ILD and RA which met the inclusion criteria were included.Using retrospective investigation,recorded the patients' gender and ESR,CRP,IgG IgA,IgM,C3,C4,RF,CCP,AKA,APF,WBC,HGB,PLT and syndrome types.Then,using chi-square test,nonparametric test,independent sample t test on the statistical software SPSS 18.0,Serological indicators,and found whether there is any difference between serological indicators in RA-ILD and RA groups,and whether there is any between the serological indicators of different syndrome types in the two groups.Results(1)Five hundred and forty seven patients were included,including 128 cases of RA-ILD and 419 cases of RA,accounting for 23.40%and 76.60%respectively.There were 113 cases of kidney deficiency and exuberant cold syndrome type,including 30 cases of RA-ILD.There were 213 cases of kidney deficiency and branch slightly hot syndrome type,including 52 cases of RA-ILD.There were 150 cases of kidney deficiency and branch seriously hot syndrome type,including 26 cases of RA-ILD.There were 71 cases of dampness-heat impairing kidney syndrome type,including 20 cases of RA-ILD.There was no s statistically significant difference between RA-ILD and RA groups in the four syndrome types(P>0.05).Whether RA-NILD or RA patients,kidney deficiency and branch slightly hot syndrome type marked the largest number,dampness-heat impairing kidney syndrome type marked the least number.(2)In terms of gender,there was a statistically significant difference between the RA-ILD and the RA groups(P<0.05).There was no statistically significant difference between RA-ILD and RA groups(P>0.05)in kidney deficiency and exuberant cold syndrome type,kidney deficiency and branch slightly hot syndrome type and kidney deficiency and branch seriously hot syndrome type.There was a statistically significant difference between RA-ILD and RA groups(P<0.05)in dampness-heat impairing kidney syndrome type.(3)In terms of ESR and CRP,there was a statistically significant difference between RA-ILD and RA groups(P<0.05).In terms of ESR,there was a statistically significant difference between RA-ILD and RA groups of patients with kidney deficiency and exuberant cold syndrome type,kidney deficiency and branch slightly hot syndrome type and kidney deficiency and branch seriously hot syndrome type(P<0.05).There was no statistically significant difference between RA-ILD and RA groups in dampness-heat impairing kidney syndrome type(P<0.05).In terms of CRP,there was a statistically significant difference between RA-ILD and RA groups of patients with kidney deficiency and exuberant cold syndrome type and kidney deficiency and branch slightly hot syndrome type.There was no statistically significant difference between RA-ILD and RA groups in kidney deficiency and branch seriously hot syndrome type and dampness-heat impairing kidney syndrome type(P<0.05).(4)In terms of IgG,IgA and IgM,there was no statistically significant difference between RA-ILD and RA groups(P>0.05).In terms of IgG,there was no statistically significant difference between RA-ILD and RA groups of patients with kidney deficiency and exuberant cold syndrome type,kidney deficiency and branch seriously hot syndrome type and dampness-heat impairing kidney syndrome type(P>0.05).There was a statistically significant difference between RA-ILD and RA groups in kidney deficiency and branch slightly hot syndrome type(P = 0.001<0.01).In terms of IgM,there was no statistically significant difference between RA-ILD and RA groups in the four syndrome types(P>0.05).(5)In terms of C3 and C4,there was no statistically significant difference between RA-ILD and RA groups(P>0.05).There was no statistically significant difference between RA-ILD and RA groups in the four syndrome types(P>0.05).(6)In terms of WBC,PLT and HBG,there was no statistically significant difference between RA-ILD and RA groups(P>0.05).In terms of WBC,there was no significant difference between RA-ILD and RA in kidney deficiency and exuberant cold syndrome type,kidney deficiency and branch slightly hot syndrome type and dampness-heat impairing kidney syndrome type(P>0.05).However,in the kidney deficiency and branch seriously hot syndrome type,there was a significant difference between the two groups(P<0.05).In terms of PLT and HBG,There was no significant difference between RA-ILD and RA groups in the four syndrome type(P>0.05).(7)In terms of different titers of rheumatoid factor(RF),there was a significant difference between RA-ILD and RA groups(P<0.01).There was a significant difference between RA-ILD and RA groups of patients with kidney deficiency and exuberant cold syndrome type,kidney deficiency and branch seriously hot syndrome type and dampness-heat impairing kidney syndrome type(P>0.05).There was a significant difference between RA-ILD and RA groups in kidney deficiency and branch slightly hot syndrome type(P<0.05).and the higher RF titers,the higher incidence of RA-ILD.(8)In terms of AKA positive,weakly positive and negative,there was a significant difference between RA-ILD and RA groups(P<0.01).there was a significant difference between RA-ILD and RA groups of patients in all syndrome type(P<0.05).In terms of APF positive and weak positive,there was a significant difference between RA-ILD and RA groups(P<0.05).There was no significant difference between RA-ILD and RA groups of patients with kidney deficiency and exuberant cold syndrome type,kidney deficiency and branch seriously hot syndrome type and dampness-heat impairing kidney syndrome type(P>0.05).But in kidney deficiency and branch slightly hot syndrome type,there was a significant difference between the two groups(P<0.05).In terms of different titers of Anti-cyclic citrullinated peptide antibody(ACCP),there was a significant difference between RA-ILD and RA groups(P<0.05).There was no significant difference between RA-ILD and RA groups in the four syndrome type(P>0.05).ConclusionAccording to the study,the author drew the following conclusions:(1)In this study,regardless of RA-NILD or RA patients,kidney deficiency and branch slightly hot syndrome type marked the largest number,dampness-heat impairing kidney syndrome type marked the least number.And there were more female than male in the two syndrome types.(2)The result suggested that there was a significant correlation between ESR and CRP and the incidence of RA-ILD.The level of ESR and CRP in RA-ILD were higher than RA-NILD group.In the four syndrome types,there were also such characteristics.(3)The level of IgA in RA-ILD group was significantly higher than that in RA-NILD group.The level of IgG in RA-ILD group was significantly higher than that in RA group alone.(4)The result suggested that there was no significant correlation between C3,C4,WBC,PLT and HBG levels and the incidence of RA-ILD.(5)The RF titer of RA-ILD group was significantly higher than that of RA-NILD group alone.The RF titer of RA-ILD group was significantly higher than that of RA group alone in the kidney deficiency and branch slightly hot syndrome type,but not in other syndromes.(6)AKA-positive,APF-positive and CCP>300 U/ml may be a risk factor for RA-ILD.The positive rate of AKA in RA-ILD group was higher than that in RA-NILD group in all syndrome type.The positive rate of APF in RA-ILD group was significantly higher than that in RA-NILD group in the kidney deficiency and branch slightly hot syndrome type.