ANKİLOZAN SPONDİLİT VE ROMATOİD ARTRİT OLGULARINDAN OLUŞAN KOLLAJEN DOKU HASTALIKLARINDA SOLUNUM FONKSİYON TESTLERİ VE KLİNİK BULGULAR

Year 2015, Volume: 29 Issue: 1, 29 - 36, 01.05.2015

Coşkun Doğan Sevda Şener Cömert Benan Çağlayan

Abstract

Amaç: Göğüs hastalıkları açısından asemptomatik olan kollajen doku hastalığına (KDH) sahip olgularda solunum fonksiyon testlerinin (SFT) önemini belirlemek. Yöntem ve Gereç: Çalışmaya Ocak 2010-Aralık 2011 tarihleri arasında hastanemizde Romatoloji Polikliniği'nde romatoid artrit (RA) ve ankilozan spondilit (AS) tanısı almış ve göğüs hastalıkları açısından asemptomatik olan 47 olgu alındı. Olguların demografik bulguları, primer KDH tanıları, hastalık süreleri, fizik muayene (FM) bulguları, arkaön akciğer grafisi (AÖAC) bulguları, sigara alışkanlıkları, solunum fonksiyon testleri (SFT) ve DLCO değerleri kayıt edildi. Olguların SFT değerler klinik ve radyolojik bulguları ile karşılaştırıldı. Bulgular: Olguların 22'si (%46.8) RA, 25'i (%53.2) AS tanısına sahip ve yaş ortalaması (45.0±12.31) yıl idi. En sık FM bulgusunun 10(%21,3) olguda inspiratuar ral olduğu, en sık AÖAC grafisi bulgusunun ise 8 (%17) olguda bilateral retikülerintersitisyel patern olduğu görüldü. Romatoid artritli ve AS'lı olgular birbirleri ile kıyaslandığında RA'lı olguların FVC, FEV1 yüzde değerleri ve DLCO değerleri AS'li gruba göre istatistiksel anlamlı olarak daha düşük bulunmuştur ((p<0,05). Fizik muayenesinde bilateral ralleri olan, AÖAC grafide
retiküler-intersitisyel patern olan ve yaşı 40’dan büyük olan olgularda FVC, FEV1 ve DLCO
değerlerinin anlamlı derecede düşük olduğu tespit edilmiştir (p<0,05). Sonuç: Kollajen doku hastalığı olan olguların solunum semptomu olmasa dahi FM bulgusu ve
radyolojik bulgu var ise akciğer tutulumu açısından tetkik edilmelidir. KDH’da SFT ucuz,
basit ve güvenilir bir başlangıç tanı aracıdır, SFT sonuçlarını klinik ve radyolojik bulgularla birlikte değerlendirilmelidir.

Keywords

Kollajen doku hastalığı, solunum fonksiyon testleri, intersitisyel akciğer hastalığı, ankylosan spondilit, romatoid artrit

PULMONARY FUNCTION TESTS AND CLINICAL FINDINGS IN CONNECTIVE TISSUE DISEASES CONSISTING OF PATIENTS WITH ANKYLOSING SPONDYLITIS AND RHEUMATOID ARTHRITIS

Abstract

Aim: To determine the significance of pulmonary function tests (PFT) in patients with connective tissue disease (CTD) and asymptomatic for chest diseases. Material and Methods: Fourty-seven patients diagnosed as RA or AS in our hospital Rheumatology Outpatient Clinic between January 2010-December 2011 were included in the study. The demographic findings, type of CTD, disease duration, physical examination (PE) findings, postero-anterior chest x-ray findings, smoking habits, pulmonary function tests (PFT) and DLCO values were recorded. Pulmonary function tests were compared with clinical and radiological findings. Results: Twenty two (46.8%) of the patients had the diagnosis of RA and 25 (53.2%) had AS with a mean age of 45.0 ± 12.3 years. The most common PE finding was inspiratory crackles at 10(21.3%) patients, and bilateral reticular-interstitial pattern was the most common of chest x-ray finding demonstrated at 8(17%) patients. When the spirometry results of the patients with RA and AS were compared, the FVC, FEV1% and DLCO values of RA cases were statistically significantly lower than AS cases (p 40 years, who had bilateral inspiratory cracles and interstitial reticular pattern were found to be significantly lower (p<0.05).
Conclusion: Patients with CTD should be examined for the lung involvement in the presence of radiological or PE findings even if they were
asymptomatic in terms of respiratory system. PFT is simple, cheap and reliable diagnostic tool at the begining; its results should be considered with clinical and radiological findings.

Keywords

Connective tissue diseases, pulmonary function tests, interstitial lung diseases. ankylosing spondylitis, rheumatoid arthritis

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