类风湿关节炎合并结核分枝杆菌感染患者的临床特征及胸部HRCT特征

doi:10.3969/j.issn.1671-7171.2025.08.007

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Abstract 【Objective】To analyze the clinical and chest high-resolution computed tomography (HRCT) features of rheumatoid arthritis (RA) patients complicated with Mycobacterium tuberculosis infection.【Methods】The clinical data of 68 RA patients complicated with Mycobacterium tuberculosis infection who were diagnosed and treated in Changsha Central Hospital from August 2023 to August 2024 were retrospectively analyzed, and their clinical and chest HRCT features were analyzed. 【Results】The main clinical manifestations of the 68 RA patients complicated with Mycobacterium tuberculosis infection were cough (41.18%), joint pain (38.24%), fever (27.94%), weight loss and fatigue (8.82%). Among them, 44 cases (64.71%) had active tuberculosis, and 24 cases (35.29%) had latent Mycobacterium tuberculosis infection. In RA patients complicated with Mycobacterium tuberculosis infection, the infection was mainly in the lungs (pulmonary tuberculosis), accounting for 83.82% (57/68); extrapulmonary tuberculosis was mainly joint tuberculosis (5.88%, 4/68); the remaining 7 cases were Mycobacterium tuberculosis-infected patients without detectable infection foci. The HRCT of 57 patients with lung involvement showed that the lesions of 6 patients were located in the typical predilection sites of pulmonary tuberculosis (i.e., the apical-posterior segment of the upper lobe or the dorsal segment of the lower lobe), the lesions of 31 patients were scattered in both lungs, the lesions of 9 patients were located in the upper lobes of both lungs, the lesions of 4 patients were located in the middle-upper lobes of both lungs, the lesions of 2 patients were located in the lower lobes of both lungs, the lesions of 2 patients were located in the upper and lower lobes of the right lung, the lesions of 1 patient were located in the three lobes of the right lung, and the lesions of 2 patients were located in the upper and lower lobes of the left lung. The chest HRCT features of the 57 patients with lung involvement were diverse. Only 4 patients showed a single HRCT feature, while most patients presented multiple HRCT features. Among them, the proportion of patients with patchy shadows, fibro-cord shadows and nodular shadows was relatively high. 【Conclusion】RA patients complicated with Mycobacterium tuberculosis infection have diverse clinical manifestations, and the infection site is mainly in the lungs. In addition, patients with lung involvement show diverse features on chest HRCT, which are prone to misdiagnosis and missed diagnosis.

Key words： Arthritis, Rheumatoid Mycobacterium tuberculosis Tomography, Spiral Computed

Received: 15 May 2025

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R593.22

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2025.08.007 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2025/V42/I8/1318

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