TỶ LỆ HIỆN MẮC VÀ CÁC YẾU TỐ NGUY CƠ CỦA BỆNH PHỔI MÔ KẼ Ở BỆNH NHÂN VIÊM KHỚP DẠNG THẤP TẠI BỆNH VIỆN ĐẠI HỌC Y DƯỢC THÀNH PHỐ HỒ CHÍ MINH

Abstract

Objective: This study investigates the prevalence of interstitial lung disease (ILD) in patients with rheumatoid arthritis (RA) and identifies associated risk factors to provide epidemiological data and support early screening strategies in Vietnam. Methods: Between September 2023 and June 2024, we conducted a cross-sectional study at the Rheumatology Outpatient Clinic, University Medical Center Ho Chi Minh City, involving 126 patients with RA diagnosed according to the 2010 ACR/EULAR criteria. Demographic, clinical, and serological data were collected. Patients with respiratory symptoms or abnormal chest X-ray underwent high-resolution computed tomography (HRCT) to confirm ILD. Multivariate logistic regression was applied to determine independent risk factors. Results: Among 126 RA patients (108 females, 18 males; mean age 54.8 ± 11.2 years), 19 (15.1%) were diagnosed with ILD. Patients with RA-ILD were older (60.3 ± 8.9 vs. 53.9 ± 11.3 years, p = 0.016), more frequently smokers (26.3% vs. 7.5%, p = 0.018), and had higher disease activity (DAS28-CRP: 4.7 ± 0.8 vs. 3.9 ± 1.0, p < 0.001). Elevated anti-CCP titers >3× ULN were more common in the ILD group (63.2% vs. 37.4%, p = 0.038). On HRCT, usual interstitial pneumonia (UIP) was the predominant pattern (63.2%), followed by nonspecific interstitial pneumonia (NSIP, 26.3%). Multivariate analysis identified smoking (adjusted OR = 3.98, 95% CI: 1.05–15.08, p = 0.042) and high disease activity (DAS28-CRP ≥3.2; adjusted OR = 4.45, 95% CI: 1.12–17.72, p = 0.034) as independent risk factors for ILD. Conclusion: Interstitial lung disease is a significant extra-articular complication of rheumatoid arthritis, with a prevalence of 15.1% in this Vietnamese cohort. Pulmonary involvement is strongly associated with smoking and high disease activity, underscoring the need for early detection and multidisciplinary management.