皮肌炎合并肺间质病变85例分析

中华皮肤科杂志 ›› 2014, Vol. 47 ›› Issue (2): 131-133.

皮肌炎合并肺间质病变85例分析

马倩倩¹,吴谦²,张立明³,肖汀⁵,李久宏²,耿龙⁶,何春涤⁵

收稿日期:2013-06-08 修回日期:2013-10-05 出版日期:2014-02-15 发布日期:2014-02-01
通讯作者: 何春涤 E-mail:chundihe@hotmail.com
基金资助:
辽宁省高等学校优秀人才支持计划

Clinical analysis of 85 cases of dermatomyositis combined with interstitial lung disease

Received:2013-06-08 Revised:2013-10-05 Online:2014-02-15 Published:2014-02-01
Contact: HE Chun-di E-mail:chundihe@hotmail.com

摘要/Abstract

摘要： 【摘要】目的探讨皮肌炎（DM）/多发性肌炎（PM）合并肺间质病变（ILD）的临床特点。方法 DM/PM患者432例，合并ILD患者85例，未合并ILD资料完整患者79例。使用SPSS17.0统计软件，计量资料用t检验，计数资料用χ2检验。结果在临床表现中，合并ILD者与无ILD者在病程中发热的患者分别为47例（55.29％），18例（22.78％），差异有统计学意义。合并ILD组有吞咽困难者9例（10.59％），较无ILD组偏少，无ILD组有吞咽困难者19例（24.05％），差异有统计学意义。实验室检查合并ILD组肌酸激酶、乳酸脱氢酶水平低于无肺间质病变组，差异有统计学意义（P < 0.05）。合并肺间质病变组免疫球蛋白IgA、IgM、IgG及γ球蛋白水平明显高于无肺间质病变组，差异有统计学意义（P < 0.05）。结论 DM/PM合并肺间质病变者更易出现发热症状，血清肌酸激酶、乳酸脱氢酶水平略升高，免疫球蛋白IgA、IgM、IgG及γ球蛋白水平明显升高，尤其是男性患者可能更易发生肺间质病变。

关键词: 皮肌炎, 多发性肌炎, 肺疾病，间质性, 回顾性研究

Abstract: Ma Qianqian, Wu Qian, Zhang Liming, Xiao Ting, Li Jiuhong, Geng Long, He Chundi *. *Department of Dermatology, No.1 Hospital of China Medical University, Shenyang 110001, China Corresponding author: He Chundi, Email: chundihe@hotmail.com 【Abstract】 Objective To analyze the clinical features of patients with dermatomyositis （DM）/polymyositis（PM） associated with interstitial lung disease（ILD）. Methods Clinical data were collected on 432 inpatients with DM/PM from September 2004 to June 2012 in the No. 1 Hospital of China Medical University. Of these patients, 85 with and 79 without complicated ILD were eligible for this study. All statistical analyses were carried out using SPSS 17.0 software. Chi-square test was performed for count data analysis, and t test for measurement data analysis. Results The incidence rate of fever was significantly higher （55.29% （47/85） vs. 22.78% （18/79）, P < 0.05）, but that of dysphagia was significantly lower （10.59% （9/85） vs. 24.05% （19/79）, P < 0.05）, in patients with complicated ILD than in those without. Moreover, the patients with complicated ILD showed significantly decreased serum levels of creatine kinase （CK） and l-lactate dehydrogenase （LDH） but increased levels of IgA, IgM, IgG and gamma globulin compared with those without complicated ILD （all P < 0.05）. Conclusions Compared with DM/PM patients without complicated ILD, those with complicated ILD are more likely to have fever with slightly elevated levels of CK, LDH and evidently elevated levels of IgA, IgM, IgG and gamma globulin in serum. Male patients with DM/PM seem to be more prone to ILD than female patients.

Key words: Dermatomyositis, Polymyositis, Lung diseases, interstitial, Retrospective studies

马倩倩吴谦张立明肖汀李久宏耿龙何春涤. 皮肌炎合并肺间质病变85例分析[J]. 中华皮肤科杂志, 2014, 47(2): 131-133.

参考文献

[1]Fat hi M, Dastmalchi M, Rasmussen E, et al.Interstitial lung disease,a common manifestation of newly diagnosed polymyositis and dermatomyositis[J].Ann Rheum Dis, 2004, 63(3):297-301
[2]Marie I, Hachulia E, Cherin P, et al.Interstitial lung disease inpolymyositis and dermatomyositis[J].Arthritis Rheum, 2002, 47(6):614-622
[3]Douglas WW, Tazelaar HD, Hartman TE, et al.Polymyositis dermatomyositis associated interstitial lung disease[J].Am J Respir Crit Care Med, 2001, 164(7):1182-1185
[4]王红, 丁丛珠, 孙凌云.以呼吸衰竭为首发表现的多发性肌炎和皮肌炎的临床分析[J].中华风湿病学杂志, 2004, 8(9):542-545
[5]Benbassat J, Gefel D, Larholt K, et al.Prognostic factors in polymyositisder -matomyositis[J].A computer-assisted analysis of ninety-two eases. Arthritis Rhenm, 1985, 28(3):249-255
[6]Bohan A, Peter JB.Polymyositis and dermatomyositis (first of two parts)[J].N Engl J Med, 1975, 292(7):344-347
[7]Fathi M, Dastmalchi M, Rasmussen E, et al.Interstitial lung disease,a common manifestation of newly diagnosed polymyositis and dermatomyositis[J].Ann Rheum Dis, 2004, 63(8):297-301
[8] Willam W, Henry D, Thomas E, et al.Polymyositis-dermatomyositis associated interstitial lung disease.Am J Respir Crit Care Med, 2001(7), 164: 1182-1185.
[9]Vassallp R, Thomas CF.Advances in treatment of rheumatic interstitial lung disease[J].Curr Opin Rheumatol, 2004, 16(3):186-191
[10]Grau JM，Mico O，Pedrol E, et al.Interstitial lung disease related to dermatomyositis,comparative study with patients without lung involvement[J].J Rheumatol, 1996, 23(11):1921-1926
[11]Marie I, Hatron PY, Hachulla E, et al.Pulmonary involvement in polymyositis and in dermatomyositis[J].J Rheumatol, 1998, 25(7):1336-1343
[12]俞宝田，甄莉，张承训，等.皮肌炎并发间质性肺病例分析[J].中华皮肤科杂志, 2003, 36(1):35-37
[13]周亚欧，左晓霞，游运辉，等.皮肌炎发性肌炎肺间质病变的临床及相关因素分析[J].中华风湿病学杂志, 2005, 9(5):318-319
[14]Chen YJ, Wu CY, Shen JL, et al.Predicting factors of interstitial lung disease in dermatomyositis and polymyositis[J].Acta Derm Venereol, 2007, 87(1):33-38

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