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包涵体肌炎的生存状况及其相关合并症。

Survival and associated comorbidities in inclusion body myositis.

机构信息

Department of Neurology.

Department of Health Sciences Research.

出版信息

Rheumatology (Oxford). 2022 May 5;61(5):2016-2024. doi: 10.1093/rheumatology/keab716.

Abstract

OBJECTIVE

To evaluate survival and associated comorbidities in inclusion body myositis (IBM) in a population-based, case-control study.

METHODS

We utilized the expanded Rochester Epidemiology Project medical records-linkage system, including 27 counties in Minnesota and Wisconsin, to identify patients with IBM, other inflammatory myopathies (IIM), and age/sex-matched population-controls. We compared the frequency of various comorbidities and survival among groups.

RESULTS

We identified 50 IBM patients, 65 IIM controls and 294 population controls. Dysphagia was most common in IBM (64%) patients. The frequency of neurodegenerative disorders (dementia/parkinsonism) and solid cancers was not different between groups. Rheumatoid arthritis was the most common rheumatic disease in all groups. A total of 36% of IBM patients had a peripheral neuropathy, 6% had Sjögren's syndrome and 10% had a haematologic malignancy. T-cell large granular lymphocytic leukaemia was only observed in the IBM group. None of the IBM patients had hepatitis B or C, or HIV. IBM patients were 2.7 times more likely to have peripheral neuropathy, 6.2 times more likely to have Sjögren's syndrome and 3.9 times more likely to have a haematologic malignancy than population controls. IBM was associated with increased mortality, with a 10-year survival of 36% from index, compared with 67% in IIM and 59% in population controls. Respiratory failure or pneumonia (44%) was the most common cause of death.

CONCLUSIONS

IBM is associated with lower survival, and higher frequency of peripheral neuropathy, Sjögren's syndrome and haematologic malignancies than the general population. Close monitoring of IBM-related complications is warranted.

摘要

目的

在一项基于人群的病例对照研究中,评估包涵体肌炎(IBM)患者的生存情况及相关合并症。

方法

我们利用扩展的罗切斯特流行病学项目病历链接系统,包括明尼苏达州和威斯康星州的 27 个县,以确定 IBM、其他炎症性肌病(IIM)患者以及年龄和性别匹配的人群对照。我们比较了各组之间各种合并症的频率和生存情况。

结果

我们确定了 50 名 IBM 患者、65 名 IIM 对照和 294 名人群对照。吞咽困难在 IBM 患者中最为常见(64%)。神经退行性疾病(痴呆/帕金森病)和实体癌的频率在各组之间没有差异。类风湿关节炎是所有组中最常见的风湿性疾病。共有 36%的 IBM 患者患有周围神经病,6%的患者患有干燥综合征,10%的患者患有血液系统恶性肿瘤。T 细胞大颗粒淋巴细胞白血病仅在 IBM 组中观察到。IBM 患者均无乙型肝炎或丙型肝炎,也无人类免疫缺陷病毒感染。与人群对照相比,IBM 患者发生周围神经病的可能性高 2.7 倍,发生干燥综合征的可能性高 6.2 倍,发生血液系统恶性肿瘤的可能性高 3.9 倍。IBM 与死亡率增加相关,从发病起 10 年生存率为 36%,而 IIM 为 67%,人群对照为 59%。呼吸衰竭或肺炎(44%)是最常见的死亡原因。

结论

与一般人群相比,IBM 患者的生存率较低,且发生周围神经病、干燥综合征和血液系统恶性肿瘤的频率较高。需要密切监测 IBM 相关并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d069/9071572/132781d0e906/keab716f1.jpg

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