140例特发性炎症性肌病合并肺间质疾病患者临床特征及中医证候分析  

Clinical Characteristics and TCM Syndrome Analysis of 140 Patients with Idiopathic Inflammatory Myopathy-associated Interstitial Lung Disease

作　　者：张宗学[1] 焦以庆[1] 王玉光[1] ZHANG Zong-xue;JIAO Yi-qing;WANG Yu-guang(Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 100010)

机构地区：[1]首都医科大学附属北京中医医院,北京100010

出　　处：《世界中西医结合杂志》2023年第7期1428-1432,共5页World Journal of Integrated Traditional and Western Medicine

基　　金：首都卫生发展科研专项项目(首发2020-2-2233);北京市属医院科研培育计划项目(PZ2020010)。

摘　　要：目的分析140例特发性炎症性肌病合并肺间质疾病(Idiopathic inflammatory myopathy associated interstitial lung disease,IIM-ILD)患者中医证候特点。方法采用回顾性研究方法,选取2016年1月—2019年10月期间首都医科大学附属北京中医医院收治的140例IIM-ILD患者,根据IIM-ILD患者的临床特点,归纳中医证候,并针对不同抗体患者的预后进行了统计分析。结果研究中不同抗体阳性患者比例为Jo-1:29例(20.70%),PL-7:27例(19.30%),EJ:21例(15.00%),PL-12:8例(5.70%),MDA5:19例(13.60%),抗体阴性:36例(25.70%)。140例患者中所占比例较高的证型为:湿热蕴肺、湿热扰营、湿热困滞肺脾。病理因素以湿、热为主。不同抗体阳性亚组患者的氧合指数、铁蛋白、LDH、CK水平比较,差异无统计学意义(P>0.05),抗MDA5抗体阳性患者生存时间短,与抗合成酶抗体阳性患者比较,差异有统计学意义(P<0.05)。结论亚组患者血清高水平铁蛋白、LDH,血气分析低氧合指数与高病死率具有相关性,提示针对IIM-ILD患者需要密切观察病情变化,并进行全面评估,积极干预治疗。Objective To analyze the characteristics of traditional Chinese medicine(TCM)syndrome in 140 patients with idiopathic inflammatory myopathy-associated interstitial lung disease(IIM-ILD).Methods A retrospective study was conducted on 140 patients with IIM-ILD who were admitted to the Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University between January 2016 and October 2019.Based on the clinical characteristics of IIM-ILD patients,TCM syndromes were summarized,and the prognosis of patients with different antibodies was statistically analyzed.Results The proportions of patients with different positive antibodies in the study were as follows.Jo-1:29 cases(20.70%),PL-7:27 cases(19.30%),EJ:21 cases(15.0%),PL-12:8 cases(5.70%),MDA5:19 cases(13.60%),and antibody-negative:36 cases(25.70%).The most common TCM syndromes among the 140 patients were dampness-heat in the lung syndrome,dampness-heat disturbing the nutrient syndrome,and dampness-heat obstructing the lung and spleen syndrome.Pathological factors were mainly related to dampness and heat.There was no statistically significant difference in the oxygenation index,ferritin,LDH,and CK levels among patients with different positive antibody subgroups(P>0.05).However,the survival time of patients with positive MDA5 antibodies was shorter compared to those with positive synthetase antibodies(P<0.05).Conclusion High levels of serum ferritin and LDH,as well as a low oxygenation index,in patients of subgroups,are associated with higher mortality rates,suggesting the need for close observation of disease progression and comprehensive assessment in patients with IIM-ILD,as well as proactive intervention and treatment.

关 键 词：特发性炎症性肌病 肺间质疾病 中医 证候 抗MDA5抗体 抗合成酶抗体 

分 类 号：R593[医药卫生—内科学]