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特发性炎症性肌病患者并发间质性肺病的血清学危险因素。

Serological risk factors for concomitant interstitial lung disease in patients with idiopathic inflammatory myopathy.

机构信息

Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan.

Department of Physical Medicine and Rehabilitation, Chi Mei Medical Centre, Chiali Branch, Tainan 722, Taiwan.

出版信息

J Clin Neurosci. 2020 Apr;74:32-35. doi: 10.1016/j.jocn.2020.01.060. Epub 2020 Jan 22.

DOI:10.1016/j.jocn.2020.01.060
PMID:31982271
Abstract

Interstitial lung disease (ILD) is an extramuscular manifestation associated with increased mortality in idiopathic inflammatory myopathy (IIM). To identify risk factors for ILD in patients with IIM, this study retrospectively enrolled 117 eligible patients from a university medical center. After a comprehensive chart review, 56 patients were stratified into ILD (n = 28) and non-ILD (n = 28) groups. Clinical features, laboratory data, concomitant diseases, and serology profiles were compared. Patients with ILD had high prevalence of anti-Jo1 antibodies (p = 0.002), anti-Ro52 antibodies (p < 0.001), both anti-Jo1 and anti-Ro52 antibodies (p = 0.008), anti-Jo1 or anti-Ro52 antibodies (p < 0.001), and lower initial creatine kinase (CK) levels (p = 0.006). Moreover, patients with anti-Ro52 antibodies and either anti-Ro52 or anti-Jo1 antibodies had 9.17-fold (95% confidence interval [CI]: 2.858-33.487, p < 0.001) and 13.44-fold (95% CI: 4.008-52.757, p < 0.001) increased odds of developing ILD, respectively. By contrast, patients with higher CK levels had 0.99-fold (95% CI: 0.999-0.999, p = 0.011) increased odds of developing ILD. Both anti-Ro52 and anti-Jo1 antibodies were independent serological risk factors for IIM-associated ILD. Because these serology tests are commonly available, they can be used to guide pulmonary screening for patients with IIM to increase neurologist proactivity in recognizing and treating extramuscular conditions.

摘要

间质性肺病(ILD)是一种与特发性炎性肌病(IIM)死亡率增加相关的肌肉外表现。为了确定 IIM 患者发生ILD 的危险因素,本研究回顾性地从一所大学医学中心纳入了 117 名符合条件的患者。经过全面的病历回顾,将 56 名患者分为ILD(n=28)和非ILD(n=28)两组。比较了两组的临床特征、实验室数据、合并症和血清学特征。ILD 患者抗-Jo1 抗体阳性率较高(p=0.002),抗-Ro52 抗体阳性率更高(p<0.001),同时存在抗-Jo1 和抗-Ro52 抗体阳性(p=0.008)、存在抗-Jo1 或抗-Ro52 抗体阳性(p<0.001),以及初始肌酸激酶(CK)水平较低(p=0.006)。此外,同时存在抗-Ro52 抗体和抗-Ro52 或抗-Jo1 抗体的患者发生ILD 的风险分别增加了 9.17 倍(95%置信区间[CI]:2.858-33.487,p<0.001)和 13.44 倍(95% CI:4.008-52.757,p<0.001)。相反,CK 水平较高的患者发生ILD 的风险增加了 0.99 倍(95% CI:0.999-0.999,p=0.011)。抗-Ro52 和抗-Jo1 抗体均为与 IIM 相关的ILD 的独立血清学危险因素。由于这些血清学检测通常都可获得,因此它们可以用于指导 IIM 患者的肺部筛查,以增加神经科医生对识别和治疗肌肉外疾病的积极性。

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