皮肌炎/多发性肌炎死亡危险因素分析

Risk factors of death in dermatomyositis/polymyositis

目的回顾性总结皮肌炎(DM)或多发性肌炎(PM)患者的临床特征,分析DM/PM死亡的独立危险因素。方法回顾性分析2016年1月~2019年9月在河北医科大学第二医院初次就诊并符合2004年国际肌病协作组建议的特发性炎症性肌病(IIM)分类诊断标准的212例DM/PM患者的临床资料,根据半年内是否死亡分为研究组(死亡组)和对照组(非死亡组),分析两组临床特点及实验室检查的差异,总结DM/PM死亡的独立危险因素。结果两组间男性、白蛋白(ALB)<35 g/L、铁蛋白升高、抗MDA5抗体阳性、肺部感染、间质性肺疾病差异有统计学意义(P<0.05);Logistic回归分析ALB<35 g/L、铁蛋白升高、抗MDA5抗体阳性、肺部感染、间质性肺疾病与DM/PM死亡密切相关(P<0.05)。结论男性、ALB<35 g/L、铁蛋白升高、抗MDA5抗体阳性、肺部感染、间质性肺疾病为DM/PM死亡的独立危险因素,提示预后不良。

Objective To retrospectively summarize the clinical characteristics of patients with dermatomyositis(DM)/polymyositis(PM),and analyze the independent risk factors of death in DM/PM.Methods The clinical data of 212 patients who had their first consultation in the Second Hospital of Hebei Medical University from January 2016 to September 2019 and met the idiopathic inflammatory myositis(IIM)classification and diagnosis criteria recommended by the international myopathy cooperation group in 2004 were retrospectively analyzed.The patients were divided into research group(death group)and control group(non-death group)according to whether they died within half a year or not.The differences in clinical characteristics of patients and laboratory examination between these two groups were analyzed to summarize the independent death risk factors of DM/PM.Results Two groups showed significant difference in male,albumin(ALB)<35 g/L,ferritin increased,positive anti-MDA5 antibody,pulmonary infection,interstitial lung disease(P<0.05).Logistic regression analysis showed that ALB<35 g/L,ferritin increase,positive anti-MDA5 antibody,pulmonary infection and interstitial lung disease closely related to death in DM/PM(P<0.05).Conclusion Male,albumin(ALB)<35g/L,ferritin increase,positive anti-MDA5 antibody,pulmonary infection,and interstitial lung disease were independent risk factors of death in DM/PM,and suggested poor prognosis.