不同统计学方法对皮肌炎患者死亡影响因素的分析

Risk factors for dermatomyositis mortality

目的探索皮肌炎患者死亡的影响因素。方法选择北京协和医院1970--1997年门诊和住院长期随诊的符合Bohan和Peter1975年诊断标准的163例皮肌炎患者，进行Cox回归分析研究及非条件Logistic回归分析。从不同角度对临床表现和相关实验室结果与死亡的关系进行研究。采用SPSS11．5统计学软件包进行统计学处理。结果Cox回归分析多因素分析结果（P〈0．05）：短病史、心脏异常、合并恶性肿瘤、肌活检阳性、皮质激素治疗时间短可能为影响生存的因素，RR分别为2．544、37．098、15．064、3．539、8．130。非条件Logistic回归分析多因素分析结果（P〈0．05）：短病史、肺纤维化、心脏异常、合并恶性肿瘤为独立的不良预后因素。OR值分别为26．315、14．440、18．756、165．030。结论对皮肌炎生存影响较大的因素是心脏异常、恶性肿瘤、短病史。提示要早诊断且注意并发症的发生，以提高皮肌炎患者的生存率。

Objective To investigate the risk factors for dermatomyositis mortality. Methods One hundred and sixty-three object from Peking Union Medical College Hospital during 1970 to 1994 were en- rolled. The criteria for the diagnosis of DM were based on the report of Bohan and Peter in 1975. The clinical and laboratory data were analyzed with the SPSS （11.5） software. Multiple factors were analysed using Cox regression and Logistic regression. Results The multiple factors analysis indicated that the risk factors for mortality were cardiac involvement, concurrent malignant tumor, abnormal muscle histopathology, shorter disease histroy and shorter time of steroid therapyin Cox regression. Relative risk was 37.098, 15.064, 3.539, 2.544, 8.130 respectively. Cardiac involvement, malignant tumor, shorter disease histrey and pulmonary fibrosis were risk factors in Logistic regression. Relative risk was 18.756, 165.030, 26.315, 14.440 respectively. Conclusion The risk factors for DM mortality are concurrent malignant tumor, cardiac involvement, and shorter disease histrey. The result can provide valuable information to guide physicians to treat certain clinical conditions of this d^sease aggressively to improve the outcome.