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特发性炎性肌病患者的长期吞咽困难严重程度:一项单中心回顾性研究。

Long-Term Dysphagia Severity in Patients With Idiopathic Inflammatory Myopathy: A Single-Center Retrospective Study.

作者信息

Ohmura Shin-Ichiro, Sato Keishiro, Nishimura Ritsu, Miyamoto Toshiaki

机构信息

Rheumatology, Seirei Hamamatsu General Hospital, Hamamatsu, JPN.

Neurology, Seirei Hamamatsu General Hospital, Hamamatsu, JPN.

出版信息

Cureus. 2024 Oct 18;16(10):e71821. doi: 10.7759/cureus.71821. eCollection 2024 Oct.

Abstract

Objective To investigate long-term dysphagia severity and survival outcomes in patients with idiopathic inflammatory myopathy (IIM). Methods We retrospectively included consecutive Japanese patients with IIM between April 2000 and March 2022. The primary endpoint was the complete oral intake rate according to the Food Intake LEVEL Scale (FILS) within one year after the onset of dysphagia in patients with IIM.The secondary outcome was the overall mortality rate in IIM patients with dysphagia.  Results Of the 108 patients with IIM, 18 (16.7%) developed dysphagia during the observation period. The baseline median dysphagia severity in IIM patients with dysphagia using the FILS was 7.0 and improved to 10.0 at the final observation. Almost all IIM patients recovered from dysphagia severity, and the complete oral intake rate within one year in IIM patients with dysphagia was 72.2%. The overall mortality rate of patients with IIM patients with dysphagia was 44.4%, which is significantly lower than that of those without dysphagia (P < 0.05). Cox regression analysis demonstrated that malignancy-associated myositis was a poor prognostic factor in patients with IIM and survival outcomes in IIM patients with dysphagia were poor compared with those in patients without dysphagia when with malignancies. Conclusions The dysphagia severity in patients with IIM improved; however, their survival rate was lower than that of those without dysphagia when malignancy occurred.

摘要

目的 探讨特发性炎性肌病(IIM)患者的长期吞咽困难严重程度及生存结局。方法 我们回顾性纳入了2000年4月至2022年3月期间连续的日本IIM患者。主要终点是IIM患者出现吞咽困难后1年内根据食物摄入水平量表(FILS)得出的完全经口摄入率。次要结局是IIM吞咽困难患者的总死亡率。结果 在108例IIM患者中,18例(16.7%)在观察期内出现吞咽困难。使用FILS评估,IIM吞咽困难患者的基线吞咽困难严重程度中位数为7.0,在最后一次观察时改善至10.0。几乎所有IIM患者的吞咽困难严重程度均有所恢复,IIM吞咽困难患者1年内的完全经口摄入率为72.2%。IIM吞咽困难患者的总死亡率为44.4%,显著低于无吞咽困难患者(P<0.05)。Cox回归分析表明,恶性肿瘤相关性肌炎是IIM患者的不良预后因素,与无吞咽困难的IIM患者相比,有恶性肿瘤的IIM吞咽困难患者的生存结局较差。结论 IIM患者的吞咽困难严重程度有所改善;然而,发生恶性肿瘤时,其生存率低于无吞咽困难的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc5a/11489808/b5737e64a95b/cureus-0016-00000071821-i01.jpg

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