多发性肌炎/皮肌炎的肺部病变特点分析

Clinical analysis of lung complications in polymyositis and dermatomyositis

目的:探讨多发性肌炎和皮肌炎(PM/DM)患者的肺部病变特点,以利于临床诊断、指导治疗。方法:回顾性分析71例PM/DM的肺部影像学、肺功能测定、超声心动图资料及相关因素,并对上述资料进行比较分析。结果:PM/DM的肺部病变发生率为54.9%,其中肺间质病变(ILD)最多见,其次为胸膜炎和肺动脉高压,肺功能异常以小气道损害为主。合并ILD组发热、关节炎和抗Jo-1抗体阳性的发生率高,而肌酸激酶(CK)、谷草转氨酶(AST)显著低于无ILD组。DM组易伴发肿瘤。结论:PM/DM患者肺部病变发生率高,以ILD多见,其发生与发热、关节炎、CK、AST、抗Jo-1抗体有相关性。小气道是PM/DM的肺部病变的主要部位。

Objective：To explore the clinical features of pulmonary involvement in patients with polymyositis and dermatomyositis（PM/DM）.Methods：The data of 71 cases of PM/DM were retrospectively reviewed,accounting for demographic and clinical parameters,chest imaging,lung function test and ultrasonic cardiography.Results：Thirty-nine （54.9%）ont of 71 patients developed PM/DM-associated lung disease,including 34 cases （47.9%）of interstitial lung disease,8 cases （11.3%）of pleuritis and 5 cases （7.0%）of pulmonary artery hypertension.Small airway dysfunction was the most common finding in pulmonary function test.The patients with interstitial lung disease had higher prevalence of fever,arthritis and anti-Jo-1 antibody positivity,however,the creatine kinase（CK） and aspartate aminotransferase（AST） were significantly lower in PM/DM patients without interstitial lung disease.DM patients were prone to complicate with tumor.Conclusion：Lung disease was observed in 54.9% patients with PM/DM.Interstitial lung disease was the main pulmonary involvement,and asso- ciated with fever,arthritis,CK,AST,and anti-Jo-1 antibody.The small airway was the most common target site in lung disease.