健康生活:風溼性關節炎可能源自肺部
Rheumatoid arthritis, a disabling disease that can inflame and deform multiple joints, may originate in the lungs, according to research published in Arthritis & Rheumatism. Elevated levels of rheumatoid-arthritis antibodies have been found in patients before the appearance of joint symptoms, suggesting RA has an early preclinical phase, researchers said. Lung disease is also associated with early RA.
呼吸道和關節炎：根據《關節炎與風溼病》（Arthritis & Rheumatism）期刊發表的一項研究，會引起多個關節發炎和變形的致殘疾病風溼性關節炎可能源自肺部。研究人員說，在關節出現炎症前就已經發現病人體內風溼性關節炎抗體水平的提高，這表明風溼性關節炎存在較早的臨牀前階段。肺部疾病也與初期風溼性關節炎存在關聯。The study examined airway abnormalities in 69 patients from Denver and Los Angeles, 42 with RA antibodies and no joint symptoms, 15 with no RA antibodies or joint symptoms, and 12 with early RA. All the participants underwent lung-function testing and CT lung imaging. Pain, stiffness or swelling were reported in at least one joint by 50% of antibody-positive and 53% of antibody-negative subjects at the time of imaging. Of the 12 with RA, three had been previously diagnosed with asthma and three with emphysema.
這項研究對來自丹佛和洛杉磯的69名呼吸道異常的患者進行了檢查，42人有風溼性關節炎抗體但無關節炎症狀，15人無風溼性關節炎抗體也無關節炎症狀，12人患有初期風溼性關節炎。所有患者都進行了肺功能檢查和肺部CT顯像。在肺顯像時，50%抗體呈陽性者和53%抗體呈陰性者表示至少有一處關節有疼痛、僵硬和腫脹。在有風溼性關節炎的12人中，三人以往曾被診斷有氣喘，三人被診斷有肺氣腫。Airway abnormalities were found in three quarters of the antibody-positive subjects, one third of the antibody-negative subjects, and nearly all the early RA subjects. Adjusting for smoking, joint tenderness, or previous lung disease didn't alter the findings. Of antibody-positive subjects, two developed RA within 13 months. Airway abnormalities seen in the study were due to inflammatory changes, researchers said.
抗體呈陽性者中有四分之三發現有呼吸道異常，抗體呈陰性者中是三分之一，幾乎所有初期風溼性關節炎患者都有呼吸道異常。綜合考慮抽菸、關節柔軟或肺病史因素後，結果也未受影響。在抗體呈陽性的人羣中，有兩人在13個月內患上風溼性關節炎。研究人員說，這項研究中所見的呼吸道異常是由於炎症變化引起的。
Caveat: Researchers didn't analyze lung tissue from subjects. The concept that RA is generated outside the joints is speculative, they said. The study was small.
注意：研究人員並未分析研究對象的肺組織。他們說，風溼性關節炎源自關節以外這一觀點目前還只是一個推測。這項研究規模較小。
