不同首发症状皮肌炎的特点分析

Characteristics of Dermatomyositis with Different Initial Symptoms

目的分析不同首发症状皮肌炎(DM)的临床特点及实验室结果。方法回顾性分析2019年1月1日至2021年1月1日就诊于郑州大学第一附属医院的136例DM患者的临床资料,根据首发症状的不同,将患者分为皮疹组、肌无力组、关节炎组、呼吸道症状组和非典型症状组。分析各组的一般特征、临床表现及实验室结果。结果在136例DM患者中,皮疹是最常见的首发症状,其次是呼吸道症状、关节炎、肌无力和非典型症状。皮疹组的抗转录中介因子1γ(TIF1γ)抗体阳性率高于关节炎组和呼吸道症状组(P<0.05)。非典型症状组的抗TIF1γ抗体阳性率也均高于关节炎组和呼吸道症状组(P<0.05)。呼吸道症状组间质性肺炎(ILD)的发生率高于皮疹组和非典型症状组(P<0.05),且呼吸道症状组的用力肺活量(FVC)和肺一氧化碳弥散率(DLCO)低于皮疹组、关节炎组和非典型症状组(P<0.05)。结论皮疹是DM最常见的首发症状,不同首发症状组在肌炎抗体类型、ILD阳性率及肺功能检查结果方面存在差异。

Objective To study the characteristics of dermatomyositis(DM)with different initial symptoms.Methods A retrospective analysis was performed on the patients who were first diagnosed with DM from January 1,2019 to January 1,2021 in the First Affiliated Hospital of Zhengzhou University.According to different initial symptoms,patients were divided into rash,myasthenia,arthritis,respiratory symptom and atypical symptom group.The general characteristics,clinical manifestations and laboratory results of each group were analyzed.Results In total 136 patients,rash was the most common initial symptoms of DM,followed by respiratory symptoms,arthritis,muscle weakness and atypical symptoms.More patients were positive for anti-transcription intermediary factor 1γ(TIF1γ)antibodies in rash groups than arthritis group and respiratory symptom group(P<0.05),and atypical symptom group had a higher positive rate of anti-TIF1γantibodies than arthritis group and respiratory group(P<0.05).Respiratory group had a higher incidence of interstitial lung disease(ILD)than rash and atypical groups(P<0.05).The forced vital capacity(FVC)and diffusion capacity of the lung for carbon monoxide(DLCO)in respiratory group were lower than those in rash,arthritis and atypical groups(P<0.05).Conclusion Rash was the most common initial symptom of DM,and there are differences in myositis antibodies,incidence of ILD,and pulmonary function tests among different subgroups.