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韩媛媛, 姜婷, 张泽昊, 等. 抗MDA5抗体阳性皮肌炎合并快速进展性间质性肺病的影响因素分析[J]. 四川大学学报（医学版）, 2023, 54(2): 422-425. DOI: 10.12182/20230360201
引用本文: 韩媛媛, 姜婷, 张泽昊, 等. 抗MDA5抗体阳性皮肌炎合并快速进展性间质性肺病的影响因素分析[J]. 四川大学学报（医学版）, 2023, 54(2): 422-425. DOI: 10.12182/20230360201
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HAN Yuan-yuan, JIANG Ting, ZHANG Ze-hao, et al. Risk Factors of Rapidly Progressive Interstitial Lung Disease in Patients With Anti-Melanoma Differentiation-Associated Gene 5 Antibody-Positive Dermatomyositis[J]. Journal of Sichuan University (Medical Sciences), 2023, 54(2): 422-425. DOI: 10.12182/20230360201
Citation: HAN Yuan-yuan, JIANG Ting, ZHANG Ze-hao, et al. Risk Factors of Rapidly Progressive Interstitial Lung Disease in Patients With Anti-Melanoma Differentiation-Associated Gene 5 Antibody-Positive Dermatomyositis[J]. Journal of Sichuan University (Medical Sciences), 2023, 54(2): 422-425. DOI: 10.12182/20230360201
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抗MDA5抗体阳性皮肌炎合并快速进展性间质性肺病的影响因素分析

Risk Factors of Rapidly Progressive Interstitial Lung Disease in Patients With Anti-Melanoma Differentiation-Associated Gene 5 Antibody-Positive Dermatomyositis

    摘要
  • 摘要:
      目的   探究抗黑色素瘤分化相关基因5（melanoma differentiation-associated gene 5, MDA5）抗体阳性皮肌炎患者合并快速进展性间质性肺病（rapidly progressive interstitial lung disease, RPILD）的情况和影响因素分析。
      方法   选取四川大学华西医院2018年1月–2021年9月确诊的抗MDA5抗体阳性皮肌炎患者，收集一般资料和临床资料，将患者分为合并RPILD组和未合并RPILD两组，筛选出可能影响抗MDA5抗体阳性皮肌炎患者合并RPILD的因素，并进行二元logistic回归分析。
      结果   在纳入的145例抗MDA5抗体阳性皮肌炎患者中，共有32人（22.07%）合并RPILD，余113人（77.93%）则均为非RPILD患者。二元logistic回归分析结果显示，乳酸脱氢酶≥370 IU/L（与“<370 IU/L”相比， 比值比=4.066，95%可信区间：1.616～10.230）、癌胚抗原≥5 ng/mL（与“<5 ng/mL”相比， 比值比=6.070，95%可信区间：2.013～18.303）是抗MDA5抗体阳性皮肌炎患者合并RPILD的危险因素（P<0.05）。
      结论   建议对乳酸脱氢酶≥370 IU/L和癌胚抗原≥5 ng/mL的患者密切关注其胸部高分辨率CT和肺功能变化，如发现有肺部病变迅速进展，需要加强本病的治疗，以改善患者的预后。

     

    Abstract:
      Objective   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.
      Methods   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.
      Results   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, OR=4.066, 95% CI: 1.616-10.230) and carcinoembryo antigen≥5 ng/mL (compared with <5 ng/mL, OR=6.070, 95% CI: 2.013-18.303) were risk factors for comorbid RPILD in patients with anti-MDA5 antibody-positive dermatomyositis (β>0, OR>1, P<0.05).
      Conclusion   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.

     

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