抗Jo-1抗体综合征15例临床及肺部影像学分析  

Clinical features and imaging findings in 15 patients with anti-Jo-1 syndrome

作　　者：吴燕芳[1] 高飞[1] 陈志涵[1] 吴晨敏 林禾 WU Yanfang;GAO Fei;CHEN Zhihan;WU Chenmin;LIN He(Department of Rheumatology and Immunology,Fujian Provincial Hospital,Provincial College of Clinical Medicine,Fujian Medical University,Fuzhou,Fujian 350001,China)

机构地区：[1]福建医科大学省立临床医学院福建省立医院风湿免疫科,福州350001

出　　处：《福建医药杂志》2020年第5期1-4,共4页Fujian Medical Journal

基　　金：福建省自然科学基金项目(2017J01170)。

摘　　要：目的分析15例抗Jo-1抗体综合征患者的临床特征、误诊原因及影像学资料,提高对该病的认识。方法收集2017年5月至2019年12月我科收治的71例特发性炎性肌病(IIM)患者的临床资料,比较Jo-1阴性组与Jo-1阳性组IIM患者的临床差异;分析15例确诊抗Jo-1抗体综合征患者的临床特点及肺部高分辨计算机断层扫描(HRCT)特征。结果1)抗Jo-1抗体综合征患者临床表现以肌炎及关节炎最常见,发生率分别为80%(12/15)、60%(9/15);2)15例(100%)出现间质性肺炎(ILD),ILD起病方式以慢性为主(86.7%,13/15),肺部HRCT以基底部(86.7%,13/15)及外周(53.3%,8/15)分布为主;磨玻璃影(53.3%,8/15)、网格影(46.7%,7/15)及少量胸腔积液(46.7%,7/15)为最常见征象;3)肺功能检查以混合性通气功能障碍为主(80.0%,12/15);4)15例患者仅5例初诊风湿免疫科,5例误诊类风湿关节炎(RA),4例误诊病毒性心肌炎,3例误诊特发性肺间质纤维化(IPF),平均误诊时间6.4个月。结论抗Jo-1综合征以呼吸道和关节症状起病较多,易误诊为IPF和RA;早期筛查抗Jo-1抗体及肺部HRCT检查,利于早期诊治,改善预后。Objective To improve the understanding of anti Jo-1 syndrome via analyzing the clinical characteristics,misdiagnosis causes and imaging data in 15 patients with this disease.Methods The data of 71 patients with inflammatory myopathy(IIM)were collected from our department from May 2017 to December 2019.The clinical differences between the anti-Jo-1 antibody negative group and the Jo-1 antibody positive group were compared.The clinical manifestations and HRCT features of15 patients with anti Jo-1 syndrome were analyzed.Results Myositis and arthritis were the most common clinical manifestations,with an incidence of 80%(12/15)and 60%(9/15).Interstitial pneumonia(ILD)occurred in 15(100%),and the onset of ILD was chronic(86.7%,13/15).The lung abnormalities were predominantly basal(86.7%,13/15)and peripheral(53.3%,8/15);ground glass opacities(53.3%,8/15),reticulations(46.7%,7/15)and few pleural effusion(46.7%,7/15)were the most common signs;mixed ventilation dysfunction was the main sign in pulmonary function examination(80.0%,12/15).Only five patients were initially diagnosed in Rheumatology Department,five patients were misdiagnosed as rheumatoid arthritis(RA),four as viral myocarditis,and three as idiopathic pulmonary pulmonary fibrosis(IPF).Conclusion Anti Jo-1 syndrome usually starts with respiratory and joint symptoms,which is most likely to be misdiagnosed as RA and IPF.Early detection of anti Jo-1 antibody and lung HRCT is conducive to early diagnosis,treatment,and improvement of prognosis.

关 键 词：抗JO-1抗体 炎性肌病 临床特征 肺部HRCT 

分 类 号：R593[医药卫生—内科学]