抗TIF1-γ抗体阳性特发性炎性肌病患者的临床特征

Clinical characteristics of idiopathic inflammatory myopathy patients with positive anti-TIF1-γantibody

目的分析抗TIF1-γ抗体阳性特发性炎性肌病(IIM)患者的临床特征。方法选取2017年5月至2020年7月于我院就诊且临床资料完善的IIM患者264例,根据肌炎特异性抗体检测结果进行分组。分别比较TIF1-γ抗体阳性组与抗体全阴性组、抗MDA5抗体阳性组及抗Jo-1抗体阳性组的临床特征。将抗TIF1-γ抗体阳性组根据是否合并恶性肿瘤进一步分为肿瘤组和非肿瘤组,比较两组的临床特征。结果抗TIF1-γ抗体阳性组患者吞咽困难、眶周皮疹、恶性肿瘤占比高于抗体全阴性组,补体C3水平、CD3^(+)、CD3^(+)CD4^(+)低于抗体全阴性组(P<0.05)。抗MDA5抗体阳性组患者吞咽困难、“V”形疹、恶性肿瘤占比及CK水平低于抗TIF1-γ抗体阳性组,Gottron征、关节炎、间质性肺炎占比及ESR、CEA、IgG水平高于抗TIF1-γ抗体阳性组(P<0.05);抗Jo-1抗体阳性组患者吞咽困难、呛咳、眶周皮疹、“V”形疹、恶性肿瘤占比低于抗TIF1-γ抗体阳性组,间质性肺炎占比及补体C3水平高于抗TIF1-γ抗体阳性组(P<0.05)。肿瘤组患者肌无力、肌痛、眶周皮疹占比高于非肿瘤组,CK、IgG水平低于非肿瘤组(P<0.05)。结论有明显肌痛、皮疹,低水平血清CK和IgG的抗TIF1-γ抗体阳性患者伴发恶性肿瘤的风险高,临床应尽早进行肿瘤筛查,以早期诊断,积极治疗。

Objective To analyze the clinical characteristics of idiopathic inflammatory myopathy(IIM)patients with positive anti-TIF1-γ antibody.Methods A total of 264 IIM patients treated in our hospital with complete clinical data from May 2017 to July 2020 were selected,and the patients were divided into groups according to the results of myositis specific antibody test.The clinical characteristics of anti-TIF1-γ antibody positive group,antibody negative group,anti-MDA5 antibody positive group and anti-Jo-1 antibody positive group were compared.The anti-TIF1-γ antibody positive group was further divided into tumor group and non-tumor group according to whether it was combined with malignant tumor,and the clinical characteristics of the two groups were compared.Results The proportion of dysphagia,periorbital rash and malignant tumor in the anti-TIF1-γ antibody positive group were higher than those in the antibody negative group,and the complement C3 level,CD3^(+),CD3^(+)CD4^(+)in the anti-TIF1-γ antibody positive group were lower than those in the antibody negative group(P<0.05).The proportion of dysphagia,V-shaped rash,malignant tumor and CK level in the anti-MDA5 antibody positive group were lower than those in the anti-TIF1-γ antibody positive group,while the proportion of Gottron sign,arthritis,interstitial pneumonia and ESR,CEA and IgG levels in the anti-MDA5 antibody positive group were higher than those in the anti-TIF1-γ antibody positive group(P<0.05);the proportion of dysphagia,cough,periorbital rash,V-shaped rash and malignant tumor in the anti-Jo-1 antibody positive group were lower than those in the anti-TIF1-γ antibody positive group,and the proportion of interstitial pneumonia and complement C3 level in the anti-Jo-1 antibody positive group were higher than those in the anti TIF1-γ antibody positive group(P<0.05).The proportion of myasthenia,myalgia and periorbital rash in the tumor group were higher than those in the non-tumor group,and the levels of CK and IgG in the tumor group were lower than those in the non-tumor group(P<0.05).Conclusion The positive anti-TIF1-γ antibody patients with obvious myalgia,rash and low levels of serum CK and IgG have a high risk of malignant tumor.Tumor screening should be carried out as soon as possible for early diagnosis and active treatment.