Chen Yi-Ju, Wu Chun-Ying, Shen Jui-Lung
Department of Dermatology, Taichung Veterans General Hospital, Taiwan.
Acta Derm Venereol. 2007;87(1):33-8. doi: 10.2340/00015555-0177.
The aim of this study was to define the predicting factors and evaluate the prognosis of interstitial lung disease in dermatomyositis/polymyositis. For the period 1995-2005, we retrospectively reviewed the clinical information and laboratory data of 56 patients who were diagnosed as definite and probable dermatomyositis and polymyositis. Interstitial lung disease is common (41.9%) in these patients. Dyspnoea and cough were the two most common initial presentations. Anti-Jo1 antibody was more common in those with interstitial lung disease. Univariate and multivariate analyses identified primary idiopathic dermatomyositis subtype, cough and dyspnoea at onset to be the three independent clinical predicting factors of interstitial lung disease. High serum lactate dehydrogenase level (>400 U/l) was inversely associated with development of interstitial lung disease (OR 0.088, p=0.031). Serum lactate dehydrogenase level and presence of anti-Jo1 antibody can serve as laboratory indicators of lung complications. Patients with malignancy and older age at onset (more than 60 years) had poorer prognosis for dermatomyositis/polymyositis (p=0.047 and p=0.035, respectively). Interstitial lung disease did not affect the survival of dermatomyositis/polymyositis patients.
本研究的目的是确定皮肌炎/多肌炎中间质性肺病的预测因素并评估其预后。在1995年至2005年期间,我们回顾性分析了56例确诊为明确和可能的皮肌炎及多肌炎患者的临床信息和实验室数据。间质性肺病在这些患者中很常见(41.9%)。呼吸困难和咳嗽是最常见的两种初始表现。抗Jo1抗体在间质性肺病患者中更为常见。单因素和多因素分析确定原发性特发性皮肌炎亚型、起病时咳嗽和呼吸困难是间质性肺病的三个独立临床预测因素。高血清乳酸脱氢酶水平(>400 U/l)与间质性肺病的发生呈负相关(OR 0.088,p=0.031)。血清乳酸脱氢酶水平和抗Jo1抗体的存在可作为肺部并发症的实验室指标。患有恶性肿瘤和起病时年龄较大(超过60岁)的皮肌炎/多肌炎患者预后较差(分别为p=0.047和p=0.035)。间质性肺病不影响皮肌炎/多肌炎患者的生存。