多发性肌炎/皮肌炎伴发静脉血栓栓塞23例临床分析  

Clinical analysis of polymyositis/dermatomyositis complicated with venous thromboembolism： a report of 23 cases

作　　者：陈雱 王鑫[3] 王迁[1] 郑文洁[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院免疫内科风湿免疫病学教育部重点实验室,100032 [2]福建医科大学附属闽东医院风湿免疫科 [3]中国中医科学院西苑医院风湿病科

出　　处：《中华风湿病学杂志》2015年第8期524-527,共4页Chinese Journal of Rheumatology

基　　金：国家自然科学基金（81471615）

摘　　要：目的 研究PM/DM伴发静脉血栓栓塞（VTE）的临床特点及可能危险因素.方法 回顾性分析2000年1月至2014年10月间北京协和医院收住院的成人PM/DM患者中伴发VTE者临床资料,采用t检验、x2检验进行数据分析.结果 PM/DM伴发VTE者23例,占同期住院PM/DM的1.86％（23/1 235）.其中PM 5例,DM 18例;男性5例,女性18例.PM与DM之间发生静脉血栓栓塞的比例差异无统计学意义,男女之间发生静脉血栓栓塞的比例差异亦无统计学意义.23例VTE患者年龄47～71岁,平均（57±7）岁,比未发生血栓的PM/DM住院患者的平均年龄（47±13）岁大（t=-3.191,P=0.001）.75％（21/28）的VTE发生在PM/DM确诊后的1年内.发生VTE者中,深静脉血栓（DVT） 18例（占1.46％,18/1 235）;肺血栓栓塞（PTE）9例（占0.73％,9/1235）,其中合并下肢DVT者4例.发生VTE时PM/DM病情多有活动和血浆D-二聚体的升高.结论 PM/DM患者存在发生VTE的风险,特别是年龄偏大患者,且可能多在PM/DM诊断后的早期发生,临床应提高认识,及早筛查并干预.Objective To investigate the clinical characteristics of polymyositis/dermatomyositis （PM/DM） complicated with venous thromboembolism （VTE）.Methods Medical records of patients with PM/DM at Peking Union Medical College Hospital from Jan 2000 to Oct 2014 were reviewed to identify VTE.The comparisons of various categorical clinical manifestations between groups were evaluated using t-test and x2 test.Results Twenty-three PM/DM patients developed VTE,which accounted for 1.86% of the 1 235 PM/DM patients hospitalized during the same period.Among these 23 patients （18 female and 5 male）,5 patients had PM and 18 patients had DM.With respect to the occurrence of VTE,no significant difference was found between DM and PM or between male and female.Their age was （57±7） years （range：47-71 years old）,significantly older than patients without thrombosis [（47±13） years,t=-3.191,P=0.001].Twenty-one patients （75%,21/28） developed VTE in the first year after the diagnosis of PM/DM.The incidence rate ratios （IRR） for DVT in PM/DM were 1.46% （18/1 235） and for PTE was 0.73% （9/1 235）,in which 4 cases complicated with lower extremity DVT.Most patients exhibited active disease and high levels of D-Dimer during the emergence of VTE.Conclusion Patients with PM/DM have an increased risk of VTE,especially in older patients and at the early stage after the diagnosis of PM/DM,indicating that more attention should be paid to these patients in the clinic.

关 键 词：多发性肌炎 皮肌炎 静脉血栓栓塞 回顾性研究 

分 类 号：R593.26[医药卫生—内科学] R543.6[医药卫生—临床医学]