摘要
目的分析皮肌炎和多发性肌炎合并间质性肺炎死亡患者的临床和实验室特征。方法对15例皮肌炎和多发性肌炎合并间质性肺炎死亡患者的临床表现、实验室检查及辅助检查等进行回顾性分析,并与23例生存者作比较。结果15例患者死亡年龄(50．1±12．0)岁,其中12例(80%)在起病半年内死亡；表现为急性或亚急性发病的间质性肺炎死亡率高,随着病程延长,肺部感染成为死亡主要原因。死亡组呼吸困难和肺部啰音出现比例、动脉氧分压降低例数与生存组比较差异有显著性。乳酸脱氢酶、谷丙转氨酶、谷草转氨酶升高明显,乳酸脱氢酶持续升高提示预后不良。肌酸磷酸激酶升高与抗Jo-1抗体阳性不是死亡的原因。结论皮肌炎和多发性肌炎早期合并间质性肺炎及随之的肺部感染是死亡的主要原因,早期关注肺部症状及积极治疗可能改善预后、降低病死率。
Objective To analyze the death causes of of dermatomyositis （DM） and polymyositis （PM） patients with interstitial pneumonia. Methods A retrospectively analysis of the clinical and laboratory characteristics of 15 dead DM and PM patients with interstitial pneumonia was carried out, and 23 survivors served as controls. Results The age of the dead group was （50. 1± 12. 0） years old, and 12 （80%） patients died within the six months after onset. The mortality was higher in the acute or subacute interstitial pneumonia patients than that in the chronic patients. With longer course of the disease, lung infections became the major cause of death. Significantly higher serum lactate dehydrogenase, glutamate - pyruvate transaminase, glutamic - oxalacetic transaminase levels were found in the dead group. The dead group had higher incidence of dyspnea and ＂ Velcro＂ - like crackles and louer arterial oxygen pressure. The elevation of lactate dehydrogenase indicated worse prognosis. The elevation of creatine kinase and anti Jo - 1 antibody werent the death causes. Conclusion The early onset of interstitial lung disease and lung infection were the major death causes in dermatomyositis and polymyositis patients. The earlier treatment of pneumonia - may improve the prognosis and reduce mortality.
出处
《中华急诊医学杂志》
CAS
CSCD
2006年第9期837-839,共3页
Chinese Journal of Emergency Medicine
关键词
皮肌炎
多发性肌炎
间质性肺炎
死亡原因
Dermatomyositis
Polymyositis
Interstitial pneumonia
Mortality
