典型皮肌炎或临床无肌炎皮肌炎并发间质性肺病的临床特点和危险因素分析

Clinical Features and Risk Factors Associated with Interstitial Lung Disease in Patients with Classic Dermatomyositis or Clinical Amyopathic Dermatomyositis

目的探讨典型皮肌炎或临床无肌炎皮肌炎(classic DM/CADM)并发间质性肺病(interstitial lung disease,ILD)与否临床特点的差异及影响ILD的危险因素。方法回顾性分析收治的121例DM患者(77例典型DM/44例CADM),采用logistic回归分析DM并发ILD的危险因素。结果典型DM患者和CADM患者ILD的发生率分别为40.3%(31/77)和50.0%(22/44),所有DM患者ILD的发生率为43.8%(53/121),单因素分析显示关节痛、干咳、气紧、血沉(ESR)、血浆白蛋白(ALB)、抗Jo-1抗体、恶性肿瘤在DM-ILD组和DM-非ILD组差异有统计学意义(P<0.05),多因素logistic回归分析显示关节痛(β=1.119,P=0.023)、干咳(β=2.423,P=0.003)、ESR(β=0.041,P=0.009)与ILD发生呈正相关。结论 ILD是典型DM和CADM常见的并发症,关节痛、干咳及高水平ESR是DM并发ILD的危险因素。

Objective To investigate the clinical features and risk factors associated with interstitial lung disease(ILD)in patients with classic dermatomyositis(classic DM)or clinical amyopathic dermatomyositis(CADM).Methods Medical records of 121DM patients(77with classic DM and 44 with CADM)were reviewed retrospectively.The risk factors associated with ILD were identified through Binary Logistic Regression analyses.Results ILD presented in 40.3%(31/77)of patients with classic DM and 50.0%(22/44)of patients with CADM.Overall,the DM patients had a prevalence of ILD of 43.8%.Univariate analyses showed that arthralgia,cough,dyspnea,anti-Jo-1antibody,malignant tumors,and the levels of Erythrocyte sedimentation rate(ESR)and Albumin(ALB)were associated with ILD.The Multivariate Logistic Regression analysis identified arthralgia(β=1.119,P=0.023),cough(β=2.423,P=0.003)and ESR(β=0.041,P=0.009)as risk factors of ILD.Conclusion ILD is a common complication of classic DM/CADM and arthralgia,cough and high level of ESR are independent risk factors of ILD.