Han Yuan-Yuan, Jiang Ting, Zhang Ze-Hao, Li Wen, Jiang Yun-di, Lu Chu-Chu, Fei Yu, Chen Bo
West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China.
Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2023 Mar;54(2):422-425. doi: 10.12182/20230360201.
To investigate the conditions of patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis combined with rapidly progressive interstitial lung disease (RPILD), and to analyze the risk factors.
A total of 145 patients diagnosed with anti-MDA5 antibody-positive dermatomyositis at West China Hospital, Sichuan University between January 2018 and September 2021 were selected, and their general and clinical data were collected. The patients were divided into two groups, a RPILD group of patients with comorbid RPILD and a non-RPILD group of those who did not have comorbid RPILD. Factors that might affect whether patients with anti-MDA5 antibody-positive dermatomyositis also had comorbid RPILD were screened out and binary logistic regression analysis was performed.
Among the 145 patients with anti-MDA5 antibody-positive dermatomyositis, 32 (22.07%) patients had comorbid RPILD, while the remaining 113 (77.93%) did not have comorbid RPILD. Binary logistic regression analysis showed that lactate dehydrogenase≥370 IU/L (compared with <370 IU/L, =4.066, 95% : 1.616-10.230) and carcinoembryo antigen≥5 ng/mL (compared with <5 ng/mL, =6.070, 95% : 2.013-18.303) were risk factors for comorbid RPILD in patients with anti-MDA5 antibody-positive dermatomyositis ( >0, >1, <0.05).
It is recommended that close attention be given to changes in high-resolution chest CT and pulmonary functions in patients with lactate dehydrogenase≥370 IU/L and carcinoembryo antigen≥5 ng/mL. If rapid progression of lung disease is detected, it is necessary to strengthen the treatment of the lung disease, thereby improving the prognosis of patients.
探讨抗黑色素瘤分化相关基因5(MDA5)抗体阳性皮肌炎合并快速进展性间质性肺病(RPILD)患者的情况,并分析危险因素。
选取2018年1月至2021年9月在四川大学华西医院确诊为抗MDA5抗体阳性皮肌炎的145例患者,收集其一般资料和临床资料。将患者分为两组,合并RPILD的患者为RPILD组,未合并RPILD的患者为非RPILD组。筛选出可能影响抗MDA5抗体阳性皮肌炎患者是否合并RPILD的因素,并进行二元逻辑回归分析。
145例抗MDA5抗体阳性皮肌炎患者中,32例(22.07%)合并RPILD,其余113例(77.93%)未合并RPILD。二元逻辑回归分析显示,乳酸脱氢酶≥370 IU/L(与<370 IU/L相比,=4.066,95%:1.616 - 10.230)和癌胚抗原≥5 ng/mL(与<5 ng/mL相比,=6.070,95%:2.013 - 18.303)是抗MDA5抗体阳性皮肌炎患者合并RPILD的危险因素(>0,>1,<0.05)。
建议对乳酸脱氢酶≥370 IU/L和癌胚抗原≥5 ng/mL的患者密切关注高分辨率胸部CT和肺功能变化。若检测到肺部疾病快速进展,有必要加强肺部疾病的治疗,从而改善患者预后。