Objective:To explore the association between the Lung Immune Prognostic Index(LIPI)and 1-year all-cause mortality in patients with idiopathic inflammatory myopathy related interstitial lung disease(IIM-ILD).Methods:Pa...Objective:To explore the association between the Lung Immune Prognostic Index(LIPI)and 1-year all-cause mortality in patients with idiopathic inflammatory myopathy related interstitial lung disease(IIM-ILD).Methods:Patients who were diagnosed with IIM-ILD at West China Hospital,Sichuan University from January 2008 to December 2021 were retrospectively included and categorized into three groups based on LIPI.Univariable and multivariable Cox proportional hazards models were conducted to explore potential association between the LIPI and patients'mortality.Results:A total of 1116 patients were screened,and 830 were included in this study.The multivariable Cox analysis showed that,compared with patients with poor LIPI,the hazard ratio(HR)for all-cause 1-year mortality was 0.22(95%CI 0.05-0.93,P=0.04)for patients in the good LIPI group(LDH<250 IU/L and dNLR<3).After excluding patients lost to follow-up within one year,a similar result was found for LIPI(HR 0.20,95%CI 0.05-0.86;P=0.03).Conclusions:Good LIPI was independently associated with decreased risk of all-cause 1-year mortality in patients with IIM-ILD.This easy-to-obtain index might be served as a potential marker for assessing the prognosis of IIM-ILD.展开更多
目的评价、总结特发性炎性肌病(idiopathic inflammatory myopathy,IIM)患者吞咽障碍管理的最佳实践证据,为其科学化管理提供依据。方法系统检索Up To Date、美国国立指南网、英国国家医疗保健优化研究所等相关指南网,欧洲吞咽障碍学会...目的评价、总结特发性炎性肌病(idiopathic inflammatory myopathy,IIM)患者吞咽障碍管理的最佳实践证据,为其科学化管理提供依据。方法系统检索Up To Date、美国国立指南网、英国国家医疗保健优化研究所等相关指南网,欧洲吞咽障碍学会、欧洲抗风湿病联盟、美国风湿病学会各专业协会网站和PubMed、Cochrane Library等数据库关于IIM患者吞咽障碍的临床决策指南、专家共识、证据总结和系统评价,检索时限为建库至2022年4月20日。由2名研究者独立完成文献质量评价和内容提取,依据证据预分级系统确定证据等级。结果共纳入20篇文献,包括1篇临床决策、5篇指南、4篇系统评价、9篇专家共识和1篇证据总结,最终形成最佳证据20条,包括多学科团队、吞咽障碍筛查与评估、药物干预等8个主题。结论吞咽障碍的早期筛查与评估对IIM患者疾病管理至关重要,医护人员应选择适宜的工具对IIM患者进行吞咽功能常规筛查,以及时识别和干预吞咽困难,减少患者营养不良及吸入性肺炎等并发症的发生率。展开更多
目的探究B细胞刺激因子(BAFF)在特发性炎性肌病(IIM)相关肺间质病变(ILD)中的临床意义。方法纳入122例IIM患者,其中86例并发ILD,按性别、年龄匹配40例正常人作为对照,采用酶联免疫吸附试验检测BAFF,分析其临床意义。结果与non-ILD组相比...目的探究B细胞刺激因子(BAFF)在特发性炎性肌病(IIM)相关肺间质病变(ILD)中的临床意义。方法纳入122例IIM患者,其中86例并发ILD,按性别、年龄匹配40例正常人作为对照,采用酶联免疫吸附试验检测BAFF,分析其临床意义。结果与non-ILD组相比,IIM-ILD组BAFF水平显著升高[2.19(1.07~4.54)ng mL vs.1.14(0.61~2.30)ng mL,P=0.005],是IIM-ILD的独立危险因素。抗MDA5抗体及抗合成酶抗体(ASA)阳性的IIM患者BAFF水平显著高于双阴性患者(P<0.05)。BAFF>3.74 ng mL时,对于诊断IIM-ILD的敏感性为36.0%,特异性为97.2%(AUC=0.681,P=0.002);联合KL-6时,对于诊断IIM-ILD的敏感性为82.6%,特异性为80.6%(AUC=0.868,P<0.001)。BAFF与铁蛋白呈正相关(r=0.368,P<0.001),与KL-6、肺部HRCT评分、肺功能无明显相关性。结论BAFF在IIM-ILD患者中显著升高,可作为IIM人群合并ILD的生物标志物。展开更多
基金supported by grants from the National High Technology Research and Development Program of China(Grant No.2022YFC3601500)Sichuan Science and Technology Program(Grant No.2020YFQ0011).
文摘Objective:To explore the association between the Lung Immune Prognostic Index(LIPI)and 1-year all-cause mortality in patients with idiopathic inflammatory myopathy related interstitial lung disease(IIM-ILD).Methods:Patients who were diagnosed with IIM-ILD at West China Hospital,Sichuan University from January 2008 to December 2021 were retrospectively included and categorized into three groups based on LIPI.Univariable and multivariable Cox proportional hazards models were conducted to explore potential association between the LIPI and patients'mortality.Results:A total of 1116 patients were screened,and 830 were included in this study.The multivariable Cox analysis showed that,compared with patients with poor LIPI,the hazard ratio(HR)for all-cause 1-year mortality was 0.22(95%CI 0.05-0.93,P=0.04)for patients in the good LIPI group(LDH<250 IU/L and dNLR<3).After excluding patients lost to follow-up within one year,a similar result was found for LIPI(HR 0.20,95%CI 0.05-0.86;P=0.03).Conclusions:Good LIPI was independently associated with decreased risk of all-cause 1-year mortality in patients with IIM-ILD.This easy-to-obtain index might be served as a potential marker for assessing the prognosis of IIM-ILD.
文摘目的探究B细胞刺激因子(BAFF)在特发性炎性肌病(IIM)相关肺间质病变(ILD)中的临床意义。方法纳入122例IIM患者,其中86例并发ILD,按性别、年龄匹配40例正常人作为对照,采用酶联免疫吸附试验检测BAFF,分析其临床意义。结果与non-ILD组相比,IIM-ILD组BAFF水平显著升高[2.19(1.07~4.54)ng mL vs.1.14(0.61~2.30)ng mL,P=0.005],是IIM-ILD的独立危险因素。抗MDA5抗体及抗合成酶抗体(ASA)阳性的IIM患者BAFF水平显著高于双阴性患者(P<0.05)。BAFF>3.74 ng mL时,对于诊断IIM-ILD的敏感性为36.0%,特异性为97.2%(AUC=0.681,P=0.002);联合KL-6时,对于诊断IIM-ILD的敏感性为82.6%,特异性为80.6%(AUC=0.868,P<0.001)。BAFF与铁蛋白呈正相关(r=0.368,P<0.001),与KL-6、肺部HRCT评分、肺功能无明显相关性。结论BAFF在IIM-ILD患者中显著升高,可作为IIM人群合并ILD的生物标志物。
