Lung disease is common in patients with rheumatoid arthritis (RA). The onset of lung involvement in RA is not well known. The objective is to describe the features and evolution of lung involvement in early RA, its relationship with disease activity parameters, smoking and treatments. Consecutive patients with early RA without respiratory symptoms were included and tracked for 5 years. Lung assessment included clinical, radiological and pulmonary function tests at diagnosis and during follow-up. Peripheral blood parameters (erythrocyte sedimentation rate, C reactive protein, rheumatoid factor and anti-citrullinated peptide autoantibodies) and scales of articular involvement, such as DAS28-CRP, were evaluated. 40 patients were included and 32 completed the 5-year follow up. 13 patients presented lung involvement in the initial 5 years after RA diagnosis, 3 of them interstitial lung disease. Significant decrease of diffusion lung transfer capacity of carbon monoxide over time was observed in six patients, 2 of them developed interstitial lung disease. DLCO decrease was correlated with higher values of CRP and ESR at diagnosis. Methotrexate was not associated with DLCO deterioration or lung disease development. Subclinical progressive lung disease correlates with RA activity parameters. Smoking status and methotrexate were not associated with development or progression of lung disease.

肺病在类风湿性关节炎 (RA) 患者中很常见。RA 肺部受累的发病机制尚不清楚。目的是描述早期 RA 肺部受累的特征和演变、其与疾病活动参数、吸烟和治疗的关系。连续纳入无呼吸道症状的早期 RA 患者并跟踪 5 年。肺评估包括诊断和随访期间的临床、放射学和肺功能测试。评估了外周血参数（红细胞沉降率、C 反应蛋白、类风湿因子和抗瓜氨酸肽自身抗体）和关节受累程度，如 DAS28-CRP。包括 40 名患者，32 名完成了 5 年的随访。13 名患者在 RA 诊断后的最初 5 年内出现肺部受累，其中 3 名患有间质性肺病。在 6 名患者中观察到随着时间的推移，一氧化碳的扩散肺转移能力显着降低，其中 2 人发展为间质性肺病。DLCO 降低与诊断时较高的 CRP 和 ESR 值相关。甲氨蝶呤与 DLCO 恶化或肺部疾病发展无关。亚临床进行性肺病与 RA 活动参数相关。吸烟状况和甲氨蝶呤与肺部疾病的发生或进展无关。DLCO 降低与诊断时较高的 CRP 和 ESR 值相关。甲氨蝶呤与 DLCO 恶化或肺部疾病发展无关。亚临床进行性肺病与 RA 活动参数相关。吸烟状况和甲氨蝶呤与肺部疾病的发生或进展无关。DLCO 降低与诊断时较高的 CRP 和 ESR 值相关。甲氨蝶呤与 DLCO 恶化或肺部疾病发展无关。亚临床进行性肺病与 RA 活动参数相关。吸烟状况和甲氨蝶呤与肺部疾病的发生或进展无关。