Predictive factors and unfavourable prognostic factors of interstitial lung disease in patients with polymyositis or dermatomyositis： a retrospective study  

作　　者：JI Su-yun ZENG Fan-qin GUO Qing TAN Guo-zhen TANG Hong-feng LUO Yi-jin TANG Zeng-qi HAN Yan-fang 

机构地区：[1]Department of Dermatology, Second Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong 510120, China

出　　处：《Chinese Medical Journal》2010年第5期517-522,共6页中华医学杂志（英文版）

摘　　要：Background Interstitial lung disease （ILD） is a serious lung complication in polymyositis （PM） and dermatomyositis （DM） which affects prognosis and requires a more aggressive approach in therapy. This study investigated the prevalence, characteristics, predictive factors and unfavourable prognostic factors of ILD in newly diagnosed PM, DM and amyopathic DM （ADM）. Methods From January 2000 to December 2008, the medical records of 197 consecutive PM and DM patients at the Second Affiliated Hospital of Sun Yat-Sen University were reviewed excluding overlapping, juvenile, and malignancy-associated cases. The patients were assigned to an ILD （69 patients） and a non-lLD group （128 patients）. The clinical features, laboratory findings, and prognosis were compared. Results The multivariate analysis indicated that older age at onset （OR 1.033, 95%C/1.009-1.058, P=0.007）, fever （OR 4.109, 95%CI 1.926-8.767, P 〈0.001） and arthritis/arthralgia （OR 2.274, 95%C/1.101-4.695, P=0.026） were the independent predictive factors for developing ILD in PM/DM after excluding anti-Jo-1. Regarding anti-Jo-1, fever （OR 4.912, 95%CI 2.121-11.376, P 〈0.001） was associated with ILD. Poor survival in ILD patients was associated with ILD clinical subset （RR 0.122, 95%CI 0.049-0.399, P 〈0.001）, ADM/DM/PM-ILD （RR 0.140, 95%C/0.031-0.476, P=0.002）, cardiac involvement （RR 4.654, 95%CI 1.391-15.577, P=-0.013） and serum albumin level （RR 0.910, 95%CI 0.831-0.997, P=-0.042）. Conclusions Patients who presented with fever tended to have a higher frequency of PM/DM-associated ILD. A Hamman-Rich-like presentation, ADM-ILD, cardiac involvement and hypoalbuminemia were poor prognostic factors in ILD-PM/DM.Background Interstitial lung disease （ILD） is a serious lung complication in polymyositis （PM） and dermatomyositis （DM） which affects prognosis and requires a more aggressive approach in therapy. This study investigated the prevalence, characteristics, predictive factors and unfavourable prognostic factors of ILD in newly diagnosed PM, DM and amyopathic DM （ADM）. Methods From January 2000 to December 2008, the medical records of 197 consecutive PM and DM patients at the Second Affiliated Hospital of Sun Yat-Sen University were reviewed excluding overlapping, juvenile, and malignancy-associated cases. The patients were assigned to an ILD （69 patients） and a non-lLD group （128 patients）. The clinical features, laboratory findings, and prognosis were compared. Results The multivariate analysis indicated that older age at onset （OR 1.033, 95%C/1.009-1.058, P=0.007）, fever （OR 4.109, 95%CI 1.926-8.767, P 〈0.001） and arthritis/arthralgia （OR 2.274, 95%C/1.101-4.695, P=0.026） were the independent predictive factors for developing ILD in PM/DM after excluding anti-Jo-1. Regarding anti-Jo-1, fever （OR 4.912, 95%CI 2.121-11.376, P 〈0.001） was associated with ILD. Poor survival in ILD patients was associated with ILD clinical subset （RR 0.122, 95%CI 0.049-0.399, P 〈0.001）, ADM/DM/PM-ILD （RR 0.140, 95%C/0.031-0.476, P=0.002）, cardiac involvement （RR 4.654, 95%CI 1.391-15.577, P=-0.013） and serum albumin level （RR 0.910, 95%CI 0.831-0.997, P=-0.042）. Conclusions Patients who presented with fever tended to have a higher frequency of PM/DM-associated ILD. A Hamman-Rich-like presentation, ADM-ILD, cardiac involvement and hypoalbuminemia were poor prognostic factors in ILD-PM/DM.

关 键 词：DERMATOMYOSITIS POLYMYOSITIS lung diseases  interstitial 

分 类 号：TN946.7[电子电信—信号与信息处理] Q463[电子电信—信息与通信工程]