多发性肌炎或皮肌炎心脏损害的临床分析

The clinical analysis of cardiac manifestation in polymyositis or dermatomyositis

目的分析多发性肌炎或皮肌炎(polymyositis/dermatomyositis,PM/DM)心脏损害的特征,探讨心脏损害发生的危险因素。方法收集423例PM/DM的临床资料,分析心脏损害的发生率、心脏损害的类型以及可能诱发心脏损害的危险因素。结果心脏损害的发生率为42.6%(180/423),表现为心肌缺血、心律失常、心包炎、心肌损害、肺动脉高压、瓣膜病变、传导阻滞、肢导低电压和其他心脏损害;多因素分析发现血沉是心脏损害发生的危险因素。结论心脏损害是PM/DM的常见并发症,表现复杂多样。血沉增快提示心脏损害的危险性增加,而与年龄、性别及病程长短等因素无关。

Objective To assess the features of cardiac involvement in polymyositis or dermatomyositis （PM/DM） and to investigate the risk factors of cardiac involvement. Methods Collecting medicl records of 423 inpatients with PM/DM and analyzing the prevalence and the type of cardiac involvement, then explore the risk factors by the multiple factor regression analysis. Results The incidence of cardiac involement was 42.6%, including myocardial ischemia, arrhythmia, myocardial injury, pericarditis, pulmonary hypertension, valve disorder, conduction block, limbs low voltage. Logistic regression analysis suggested that ESR was the possible risk factor of cardiac involvement. Conclusion Cardiac involvement is a usual complication of PM/DM; the cardiac incidence raises up with ESR and it is not associated with age, gender, duration of PM/DM.