Department of Allergy and Immunological Diseases, Tokyo Metropolitan Komagome Hospital, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo, Japan.
Rheumatol Int. 2013 Sep;33(9):2381-9. doi: 10.1007/s00296-013-2735-y. Epub 2013 Apr 4.
The aim of this study was to determine whether skin ulcer can be used as a predictive and prognostic factor of acute/subacute interstitial lung disease (ILD) in Japanese patients with dermatomyositis (DM). We reviewed the medical records of 39 consecutive DM patients who were admitted to Tokyo Metropolitan Komagome Hospital from January 2000 to December 2009. The mean follow-up period was 63.9 ± 51.6 months. Fifteen patients had acute/subacute ILD and 11 patients had chronic ILD. Seven out of 15 acute/subacute ILD led to respiratory failure and 3 of them died due to ILD. Skin ulcers were observed in 5 out of 15 patients with acute/subacute ILD (33.3 %) and in 2 out of 24 patients without acute/subacute ILD (8.3 %). The presence of skin ulcers was revealed to be a significant predictive factor for acute/subacute ILD among various parameters by multivariate analysis. In the 15 patients with acute/subacute ILD, the presence of skin ulcers was a significant poor prognostic factor (p = 0.0231) and the cumulative survival rate of patients with skin ulcers was 53.3 % for 12 months. Skin ulcer is a significant predictive and prognostic factor of acute/subacute ILD in patients with DM.
本研究旨在确定皮肤溃疡是否可作为预测和判断日本皮肌炎（DM）患者急性/亚急性间质性肺病（ILD）的指标。我们回顾了 2000 年 1 月至 2009 年 12 月期间在东京都驹込医院住院的 39 例连续 DM 患者的病历。平均随访时间为 63.9 ± 51.6 个月。15 例患者患有急性/亚急性 ILD，11 例患者患有慢性 ILD。15 例急性/亚急性 ILD 中有 7 例导致呼吸衰竭，其中 3 例死于 ILD。在 15 例急性/亚急性 ILD 患者中有 5 例（33.3%）出现皮肤溃疡，在 24 例无急性/亚急性 ILD 患者中有 2 例（8.3%）出现皮肤溃疡。多因素分析显示，皮肤溃疡是各种参数中预测急性/亚急性 ILD 的显著指标。在 15 例急性/亚急性 ILD 患者中，皮肤溃疡是一个显著的预后不良因素（p = 0.0231），溃疡患者的累积生存率为 12 个月时的 53.3%。皮肤溃疡是 DM 患者急性/亚急性 ILD 的一个显著预测和预后指标。
