特发性间质性肺炎患者肌炎特异性抗体的预后价值。
Prognostic value of myositis-specific antibodies in patients with idiopathic interstitial pneumonia.
机构信息
Division of Respiratory Medicine, Department of Internal Medicine, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba, 285-8741, Japan.
Division of Rheumatology, Department of Internal Medicine, Toho University Sakura Medical Center, Sakura, Japan.
出版信息
BMC Pulm Med. 2024 Oct 10;24(1):503. doi: 10.1186/s12890-024-03326-w.
BACKGROUND
Patients with idiopathic interstitial pneumonia (IIP) often exhibit positivity for myositis-specific antibodies (MSA). However, the significance of this finding remains unclear. In this study, we investigated the association of MSA with the prognosis and risk of acute exacerbation in patients with IIP.
METHODS
We retrospectively reviewed the medical records of patients with IIP and examined the effect of each MSA subtype on survival and acute exacerbation.
RESULTS
Of 240 patients with IIP, 48 (20%) exhibited positivity for MSA. The MSA subtypes included: PL-7 (antithreonyl; n = 16, 6.7%); signal recognition particle (n = 13, 5.4%); PL-12 (antialanyl; n = 9, 3.8%); Mi-2 (n = 8, 3.3%); OJ (anti-isoleucyl; n = 7, 2.9%). During the 382 days (382 ± 281 days) of observation, 32 (13%) patients expired, and 27 (11%) experienced an acute exacerbation. Cox proportional hazards regression analysis demonstrated that age at the initial visit (hazard ratio [HR]: 1.072; 95% confidence interval [CI]: 1.017-1.131; P = 0.01), PL-7 (HR: 4.785; 95% CI: 1.528-14.925; P = 0.007), and PL-12 (HR: 3.922; 95% CI: 1.198-12.82; P = 0.024) were independent predictors of survival time. PL-7 (HR: 3.268; 95% CI: 1.064-10; P = 0.039) and PL-12 (HR: 5.747; 95% CI: 1.894-7.544; P = 0.002) were independent predictors of time from first visit to acute exacerbation.
CONCLUSION
Detecting MSA in patients with interstitial lung disease may be useful in predicting prognosis and providing a rationale for intensive treatment.
背景
特发性间质性肺炎（IIP）患者常表现出肌炎特异性抗体（MSA）阳性。然而，这一发现的意义尚不清楚。本研究旨在探讨 MSA 与 IIP 患者的预后和急性加重风险的关系。
方法
我们回顾性分析了 240 例 IIP 患者的病历，并检查了每种 MSA 亚型对生存和急性加重的影响。
结果
在 240 例 IIP 患者中，有 48 例（20%）检测到 MSA 阳性。MSA 亚型包括：PL-7（苏氨酰；n=16，6.7%）；信号识别颗粒（n=13，5.4%）；PL-12（丙氨酰；n=9，3.8%）；Mi-2（n=8，3.3%）；OJ（异亮氨酰；n=7，2.9%）。在 382 天（382±281 天）的观察期内，有 32 例（13%）患者死亡，27 例（11%）发生急性加重。Cox 比例风险回归分析表明，初诊时的年龄（风险比[HR]：1.072；95%置信区间[CI]：1.017-1.131；P=0.01）、PL-7（HR：4.785；95%CI：1.528-14.925；P=0.007）和 PL-12（HR：3.922；95%CI：1.198-12.82；P=0.024）是生存时间的独立预测因素。PL-7（HR：3.268；95%CI：1.064-10；P=0.039）和 PL-12（HR：5.747；95%CI：1.894-7.544；P=0.002）是从初诊到急性加重时间的独立预测因素。
结论
在间质性肺疾病患者中检测 MSA 可能有助于预测预后，并为强化治疗提供依据。
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