血清 IgA 水平预测皮肌炎中快速进展性间质性肺病的发生。
Serum IgA levels for predicting the development of rapidly progressive interstitial lung disease in dermatomyositis.
机构信息
Department of Rheumatology and Immunology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, China.
出版信息
Respir Med. 2023 Sep;216:107322. doi: 10.1016/j.rmed.2023.107322. Epub 2023 Jun 9.
BACKGROUND
Some patients with dermatomyositis (DM) can develop rapidly progressive interstitial lung disease (RPILD) that is resistant to treatment and life-threatening. Convenient and practical predictive factors for the development of RPILD are currently lacking. We aimed to identify independent risk factors for RPILD in patients with DM.
METHODS
A total of 71 patients with DM admitted to our hospital between July 2018 and July 2022 were retrospectively reviewed. Risk factors to predict RPILD were identified by univariate and multivariate regression analyses, and significant variates for RPILD were included to establish a risk model.
RESULTS
Multivariate regression analysis revealed that the risk of RPILD was significantly associated with serum IgA levels. The area under the risk model curve, established by IgA levels combined with other independent predictors including the anti-melanoma differentiation-associated gene 5 (MDA5) antibody, fever, and C-reactive protein, was 0.935 (P < 0.001).
CONCLUSION
A higher serum IgA level was identified as an independent risk factor for RPILD in patients with DM.
背景
部分皮肌炎（DM）患者可发生治疗抵抗且危及生命的快速进展性间质性肺病（RPILD）。目前尚缺乏用于预测 RPILD 的简便实用的预测因素。本研究旨在明确 DM 患者发生 RPILD 的独立危险因素。
方法
回顾性分析 2018 年 7 月至 2022 年 7 月我院收治的 71 例 DM 患者的临床资料。采用单因素和多因素回归分析识别预测 RPILD 的危险因素，并将 RPILD 的显著变量纳入建立风险模型。
结果
多因素回归分析显示，血清 IgA 水平与发生 RPILD 的风险显著相关。IgA 水平联合其他独立预测因子（包括抗黑色素瘤分化相关基因 5（MDA5）抗体、发热和 C 反应蛋白）建立的风险模型曲线下面积为 0.935（P<0.001）。
结论
血清 IgA 水平升高是 DM 患者发生 RPILD 的独立危险因素。
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