216例皮肌炎预后因素的统计分析

Prognostic Factors in Dermatomyositis: An Analysis of 216 Cases

目的探索皮肌炎患者致死的危险因素。方法收集北京协和医院1970～1997年门诊和住院长期随诊的216例患者 ,符合Bohan和Peter1975年的诊断标准。随诊2～27年 ,平均(5 8±4 7)年。以临床资料和实验室各指标为参数 ,借助计算机SAS和Stata软件 ,用 χ2 检验和Logistic回归法对预后因素进行分析。结果216例患者中43例死亡(19 9 %)。24例(11 1 %)伴发恶性肿瘤 ,死亡18例。合并肺纤维化32例(14 8 %) ,死亡13例。发病第1年病死率最高占患者9 7 % ,第2年和第5年的生存率分别为87 5 %、81 5 %。致死的危险因素为肺纤维化、恶性肿瘤和急性发病。老人和心脏疾患为非致死的危险因素。结论肺纤维化。

Objective To investigate the life threatening factors of dermatomyositis(DM) Methods 216 cases of DM were collected from the Peking Union Medical College Hospital in 1970 to 1997 The criteria for the diagnosis of DM were based on the report of Bohan and Peter in 1975 The mean follow up period of these patients was 5 8±4 7 years (ranged from 2 to 27 years) The clinical and laboratory data were retrospectively analysed with the SAS and Stata statistical software package, chisquare test was used for monofactorial study, and multiple factors were analysed using logistic regression Results There were 43 out of 216 DM patients (19 9%) died; among them, 18 out of 24 (11 1%) complicated with malignancy, 13 out of 32(14 8%)complicated with pulmonary fibrosis During the first year after onset, the mortality rate was quite high (9 7%) The survival rates were 87 5% in the second year and 81 5% in the fifth year respectively Life threatening factors were malignancy,pulmonary fibrosis and acute onset of the disease Aging and cardiac disorders were not identified as a fatal risk factor in this series of patients Conclusion Poor prognostic factors in DM were malignancy, pulmonary fibrosis and acute onset of the disease