摘要
目的总结分析皮肌炎(dermatomyositis,DM)并发间质性肺疾病(interstitial lung disease,ILD)的临床特征,探讨患者预后不良的预测指标。方法选取在苏州大学附属第一医院住院治疗的268例DM患者作为研究对象,收集包括症状、体征、实验室检查、心电图、肺功能检查等资料及预后进行回顾性研究。结果相较于单纯DM患者,伴发ILD的患者出现发热、关节痛、呼吸道症状、抗核抗体(ANA)阳性、抗Jo-1抗体阳性,以及血沉(ESR)、乳酸脱氢酶(LDH)、IgG升高的概率明显升高。而当后者出现以下一种或几种表现,如:发热、Gottron皮疹、心脏损害、关节痛、合并感染,血清ESR、LDH指标升高、肌酸激酶(CK)低水平时,患者的病死率升高。结论对于DM患者,应尽早常规行肺功能及高分辨率CT(HRCT)检查。当DM伴ILD患者出现发热、关节痛、心脏损害、合并感染、CK低水平等表现时,需及早干预。
Objective To analyze the clinical characteristics of dermatomyositis（DM） with interstitial lung disease（ILD）,and to investigate the unfavorable prognostic factors.Methods The data of 268 DM patients who were admitted to the First Affiliated Hospital of Soochow University were collected,and the findings of laboratory examination,pulmonary function and others were retrospectively analyzed.Results The study indicated that the DM patients with ILD showed much higher probability in presenting fever,arthralgia,respiratory symptoms compared to DM patients.The mortality increased when DM patients with ILD had a fever,Gottron rashes,cardiac damage,arthralgia,infection,high level of serum ESR and LDH,and low level of serum CK.Conclusion Chest high-resolution CT and pulmonary function test should be recommended as early screening tools for DM patients.When some clinical manifestations such as fever,arthralgia,cardiac damage,infection,and low level of CK occurred,intervention should be performed as early as possible.
出处
《临床荟萃》
CAS
2014年第3期301-304,共4页
Clinical Focus
关键词
皮肌炎
肺疾病
间质性
预测
预后
dermatomyositis
lung diseases, interstitial
forecasting
prognosis
