老年皮肌炎伴发肿瘤的相关因素分析

Analysis of related factors of senile dermatomyositis with tumor

目的探讨老年皮肌炎(DM)伴发肿瘤的相关因素分析。方法选择2015年1月至2019年1月在陆军军医大学第一附属医院皮肤科治疗的老年DM患者230例作为研究对象,根据影像学及组织病理学诊断结果,分为伴发肿瘤组56例与未伴发肿瘤组174例。统计DM患者伴发肿瘤的分布类型,采用单因素分析影响老年DM伴发肿瘤的相关因素;采用多因素Logistic回归分析影响老年DM伴发肿瘤的危险因素。调查因素包括性别、年龄、体质量指数(BMI)、病程、肺间质病变、皮肤异色样皮损、吞咽困难、雷诺现象、红细胞沉降率、心脏异常。结果纳入的230例老年DM患者中,并发肿瘤56例,检出率为24.35%,其中以呼吸系统和消化系统肿瘤最常见。经单因素分析结果显示,两组性别、BMI、肺间质病变、雷诺现象和心脏异常比较差异无统计学意义(P>0.05);两组年龄、病程、皮肤异色样皮损、吞咽困难和红细胞沉降率比较差异有统计学意义(P<0.05)。将上述单因素分析差异有统计学意义的数据纳入多因素分析结果显示,年龄、病程、皮肤恶性红斑、吞咽困难和红细胞沉降率是影响老年DM伴发肿瘤的危险因素。结论老年DM伴发肿瘤的危险因素较多,尤其是伴有皮肤异色样皮损、吞咽困难及红细胞沉降率增快的患者应高度警惕恶性肿瘤的发生,加强DM早期患者恶性肿瘤的严格筛查工作。

Objective To explore the related factors of dermatomyositis(DM)complicated with tumors in the elderly.Methods The 230 elderly patients with DM who were treated in our hospital from January 2015 to January 2019 were selected as the research objects.According to the results of imaging and histopathological diagnosis,they were divided into 56 patients with concurrent tumors and 174 patients without concurrent tumors.The distribution types of tumors in patients with DM were analyzed by single factor analysis,and the risk factors of tumors in elderly patients with DM were analyzed by multivariate Logistic regression.The investigation factors included gender,age,body mass index(BMI),course of disease,pulmonary interstitial lesions,skin heterochromatoid lesions,dysphagia,erythrocyte sedimentation rate,ESR velocity and abnormal heart.Results Among 230 elderly patients with DM,56 were complicated with tumors,the detection rate was 24.35%.Respiratory and digestive system tumors were the most common.The results of univariate analysis showed that there were no significant differences in gender,BMI,pulmonary interstitial lesions.Reynolds phenomenon and cardiac abnormalities between the two groups(P>0.05);there were significant differences in age,course of disease,skin heterochromatoid lesions,dysphagia and erythrocyte sedimentation rate between the two groups(P<0.05).The results of multivariate analysis showed that age,course of disease,skin malignant erythema,dysphagia and sedimentation rate were the risk factors of senile DM complicated with tumors.Conclusion There are many risk factors for DM complicated with tumor in the elderly,especially those with skin heterochromatoid lesions,dysphagia and rapid erythrocyte sedimentation rate.We should pay more attention to the occurrence of malignant tumor and strengthen the strict screening of early DM patients.