Nara Mizuho, Komatsuda Atsushi, Omokawa Ayumi, Togashi Masaru, Okuyama Shin, Sawada Ken-Ichi, Wakui Hideki
Department of Hematology, Nephrology, and Rheumatology, Akita University Graduate School of Medicine , Akita , Japan.
Mod Rheumatol. 2014 Jul;24(4):633-6. doi: 10.3109/14397595.2013.844390. Epub 2013 Nov 4.
Rapidly progressive interstitial lung disease (RP-ILD) is life-threatening in patients with clinically amyopathic dermatomyositis (CADM). Useful prognostic markers are necessary for treatment selection. This study aimed to investigate differences in clinical and laboratory characteristics between surviving and non-surviving patients.
Twelve CADM patients with RP-ILD were enrolled. Six patients lived (Group A) and six patients died (Group B) after immunosuppressive treatment for RP-ILD. Clinical manifestations and laboratory data before treatment were compared between the two groups.
Among the clinical manifestations and laboratory data examined, serum interleukin 6 (IL-6) levels in Group B were significantly higher than those in Group A (mean ± SD 28.5 ± 21.0 vs. 7.2 ± 1.6 pg/mL; p = 0.009). Simple regression analysis showed that serum IL-6 was the only significant prognostic factor (p = 0.032). Kaplan-Meier estimates showed that the cumulative survival rate was significantly lower in patients with serum IL-6 levels of ≥ 9 pg/mL than in patients with those of < 9 pg/mL (p = 0.04).
Serum IL-6 levels may predict the prognosis of CADM patients with RP-ILD. The intensity of immunosuppressive treatment can be decided according to serum IL-6 levels at an early phase of the disease.
快速进展性间质性肺病（RP-ILD）对于临床无肌病性皮肌炎（CADM）患者具有生命威胁。治疗选择需要有用的预后标志物。本研究旨在调查存活与非存活患者在临床和实验室特征方面的差异。
纳入12例患有RP-ILD的CADM患者。6例患者在接受针对RP-ILD的免疫抑制治疗后存活（A组），6例患者死亡（B组）。比较两组治疗前的临床表现和实验室数据。
在所检查的临床表现和实验室数据中，B组血清白细胞介素6（IL-6）水平显著高于A组（均值±标准差 28.5±21.0 vs. 7.2±1.6 pg/mL；p = 0.009）。简单回归分析显示血清IL-6是唯一显著的预后因素（p = 0.032）。Kaplan-Meier估计显示，血清IL-6水平≥9 pg/mL的患者累积生存率显著低于<9 pg/mL的患者（p = 0.04）。
血清IL-6水平可能预测患有RP-ILD的CADM患者的预后。免疫抑制治疗强度可根据疾病早期的血清IL-6水平来决定。
