皮肌炎合并肺间质病变85例分析  

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

作　　者：马倩倩[1] 吴谦[1] 张立明[1] 肖汀[1] 李久宏[1] 耿龙[1] 何春涤[1] 

机构地区：[1]中国医科大学附属第一医院皮肤科,沈阳110001

出　　处：《中华皮肤科杂志》2014年第2期131-133,共3页Chinese Journal of Dermatology

基　　金：辽宁省高等学校优秀人才支持计划（LR201040）

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。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.

关 键 词：皮肌炎 多发性肌炎 肺疾病 间质性 回顾性研究 

分 类 号：R593.26[医药卫生—内科学]