40例皮肌炎并发肺间质病变的临床分析  

Clinical analysis of 40 patients with dermatomyositis complicated with interstitial lung disease

作　　者：代丽美[1] 陈爱明[1] 季成[2] 王彩梅[1] 杨玉花[1] 

机构地区：[1]苏州大学附属第一医院皮肤科,江苏苏州215006 [2]苏州大学附属第一医院呼吸科,江苏苏州215006

出　　处：《临床皮肤科杂志》2009年第7期434-436,共3页Journal of Clinical Dermatology

摘　　要：目的:探讨皮肌炎(DM)并发肺间质病变(ILD)的临床特点。方法:采用回顾性方法对167例DM患者的临床资料及实验室指标进行分析。结果:男女之比为1:2.06。DM患者并发ILD者占23.95%,男性并发ILD(34.54%)高于女性(18.75%),ILD组的平均患病年龄[(52.03±12.22)岁]大于无ILD组[(45.34±17.43)岁]。ILD组出现异色病样皮损、四肢肌无力和关节痛者高于无ILD组,而有双上眼睑和(或)眶周红斑的为无ILD组高于ILD组。在ILD组中,抗核抗体(ANA)和抗Jo-1抗体的阳性率分别为64.86%和32.43%,均大于无ILD组;ILD组的血清乳酸脱氢酶(LDH)、血沉(ESR)和心电图ST-T改变高于无ILD组。结论:年龄较大的男性DM患者,尤其伴ANA、抗Jo-1抗体阳性,血清LDH显著升高、ESR增快、ST-T改变、四肢肌无力、有关节痛以及异色病样皮损者更易并发ILD。Objective： To investigate the clinical characteristics of the patients with dermatomyostisis（DM） complicated with interstitial lung disease（ILD）. Methods： The clinical manifestations and the laboratory data of the 167 patients with DM were retrospectively analyzed. Results： The ratio of male to female was h 2.06. There were 23.95% of the DM patients complicated with ILD, with an older average age （ 52.03±12.22 years） than those without ILD （45.34±17.43 years）. 34.54% of the male DM patients were complicated with ILD which were more common than those in the famales（18.75%）. Poikiloderma, muscular weakness and arthritis were more common in those complicated with ILD, and vice versa for heliotrope rash on the upper eyelids and （or） around the orbit. The positive anti-ANA antibody and positive anti-Jo-1 antibody were more frequent in those complicated with ILD （64.86% and 32.43%, respectively） than those without ILD. Similarly, higher surum level of LDH, increased ESR and more ST-T changes in EKG were more frequent in the patients with ILD. Conclusion： These data indicate that the DM patients complicated with ILD are likely to occur in the elder males with poikiloderma, muscular weakness, arthritis, positive ANA and anti-Jo-I antibodies, higher level of serum LDH and ESR, as well as ST-T changes of EKG.

关 键 词：皮肌炎 间质性肺病 

分 类 号：R593.26[医药卫生—内科学]