中文摘要：

[目的] 探讨类风湿性关节炎-相关间质性肺病（RA-ILD）的中医证型特征和影响RA-ILD早发的风险因素。[方法] 筛选RA-ILD住院电子病历，提取性别、年龄、吸烟史、症状、体征、RA中医证型、RA诊断时间、RA-ILD诊断时间和胸部高分辨率CT（HRCT）特征等资料，采用回顾性分析，评价RA-ILD发病时间、病理学分型和早发影响因素。[结果] 筛选130例，剔除11例，纳入研究119例，其中肝肾阴虚型54例、气血两虚型36例、风湿热郁型19例、风寒湿阻型10例。发病时间比较，全部病例平均发病时间约11 a，中位发病时间约7 a，平均和中位发病时间均呈风湿热郁型〈风寒湿阻型〈气血两虚型〈肝肾阴虚趋势，差异均有统计学意义（P〈0.05）；病理学分型以普通性间质性肺炎（UIP，65.5%）和非特异性间质性肺炎（NSIP，30.3%）为主，风湿热郁型（52.6%）和肝肾阴虚型（96.3%）UIP发生率高，风寒湿阻型（90.0%）和气血两虚型（55.6%）NSIP发生率高，组间比较，差异均有统计学意义（P〈0.05）。多因素Cox比例风险回归分析，RA中医证型是RA-ILD早发（≤ 7 a）的影响因素，RA实证与虚证相比，RA-ILD早发风险增加约2倍（HR 2.972，95%CI：1.775，4.976）。[结论] RA中医分型与RA-ILD病理类型有一定对应关系，风湿热郁型和风寒湿阻型RA更易早发RA-ILD，该结论尚需前瞻性研究确证。

英文摘要：

[Objective] To investigate the characteristics of traditional Chinese medicine （TCM） syndrome and influence factors related to early onset of rheumatoid arthritis-associated interstitial lung disease （RA-ILD）.[Methods] Clinical data, such as gender, age, smoking history, symptoms and signs, TCM syndrome, diagnostic time for RA and RA-ILD and characteristics of chest HRCT, of inpatient with RA-ILD, were analyzed retrospectively. Onset time, pathological types and influence factors related to early onset of RA-ILD were evaluated.[Results] A total of 130 patients were filtered and 11 patients were deleted. So 119 patients were identified, of whom 54 liver-kidney yin deficiency type, 36 asthenia of qi and blood type, 19 beriberoid pyretic arthralgia type and 10 wind-cold-damp retention type. The mean and median onset time respectively were 11 years and 7 years of these patients, and both of them showed a trend as beriberoid pyretic arthralgia type 〈 wind-cold-damp retention type 〈 asthenia of qi and blood type 〈 liver-kidney yin deficiency type with significant differences. UIP （65.5%） and NSIP （30.3%） were the main pathological types. Iincidence rate of beriberoid pyretic arthralgia type （52.6%） and liver-kidney yin deficiency type（96.3%） in UIP and wind-cold-damp retention type（90.0%） and asthenia of qi and blood type（55.6%） in NSIP were significant higher. The results of multivariate Cox proportional hazards regression analysis showed that TCM syndrome of RA was the influence factor related to early onset（≤ 7 years） of RA-ILD, and excess syndrome of RA raised the risk two times.[Conclusion] There is a certain degree of correlation between TCM syndrome of RA and pathological type of RA-ILD, and onset times of RA-ILD of beriberoid pyretic arthralgia type and wind-cold-damp retention type are earlier than the other types. This conclusion should be further confirmed by prospective studies.