%0 Journal Article
%T 炎性肌病患者肺部病变特点分析
%A 李莉
%A 谢其冰
%A 刘怡欣
%A 李昕怡
%A 刘毅
%A 刘钢
%J 华西医学
%P 646-650
%D 2011
%X 【】　目的　探讨新诊断的多发性肌炎（PM）、皮肌炎（DM）和无肌病性皮肌炎（ADM）肺部病变发生率、临床特点及相关因素。　方法　回顾性分析2008年1月―2010年7月新确诊的206例PM、DM、ADM临床表现、肺部影像学、肺功能、超声心动图和实验室指标。　结果　206例患者中合并肺部病变156例，以肺间质病变（ILD）最多见，占患者总数的51.46%。在性别、病程、是否吸烟方面合并ILD与无ILD患者相比差异无统计学意义，合并ILD患者年龄大于无ILD组。合并ILD患者呼吸困难、发热、雷诺现象、关节炎或关节痛概率增加。合并ILD组白蛋白低于无ILD组，血沉和免疫球蛋白IgM高于无ILD组。急性ILD组中女性患者及出现雷诺现象的概率高于慢性组。206例患者中死亡13例，其中周围型肺癌1例，特发性血小板减少并颅内出血1例，严重肺部感染11例；死亡患者中10例伴肺间质纤维化。合并急性ILD患者死亡率较慢性组高2倍。　结论　PM、DM、ADM患者肺部病变发生率高，以ILD多见，发热、年龄大、白蛋白降低、血沉升高、雷诺现象及关节炎或关节痛都是合并ILD的相关因素。合并急性ILD患者预后差，死亡者常合并肺部感染。【Abstract】　Objective　Toexploretheprevalence,clinicalfeatures,andpredictivefactorsofpulmonaryinvolvementinnewlydiagnosedpolymyositis(PM),dermatomyositis(DM)andamyopathicdermatomyositis(ADM),inordertocarryoutearlydiagnosisandtreatment,andimprovetheprognosis.　Methods　Theclinicalmanifestations,chestimaging,pulmonaryfunctiontest,ultrasoniccardiographyandlaboratoryresultsof206inpatientswithPM,DMandADMinWestChinaHospitalofSichuanUniversityfromJanuary2008toJuly2010werereviewedretrospectively.　Results　Onehundredandfifty-sixoutof206patientsdevelopedPM/DM/ADMassociatedlungdiseases,including106cases(51.46%)ofinterstitiallungdisease(ILD).Therewasnosignificantdifferenceingender,diseaseduration,andsmokingornotbetweentheILDandnon-ILDgroup,butpatientsintheILDgroupweresignificantlyolderthannon-ILDgroup.TheresultsalsoshowedthatpatientswithILDweremuchmorelikelytohavesymptomsofbreathingdifficulties,fever,Raynaudphenomenonandarthritis/arthralgia.ThepatientswithILDhadlowerlevelofalbuminbuthigherlevelsofESRandIgM;InthegroupofacuteILD,femalepatientsandtheratioofRaynaudphenomenonwerehigherthanthoseinthechronicitygroup.Ofthe206patients,13patientsdied,including1deathofperipherallungcancer,1ofessentialthrombocytopeniaandintracranialhemorrhages,and11ofseverelunginfection,and10inthesepatientsdevelopedILD.MortalityinpatientswithacuteILDwas2timeshigherthanthechronicitygroup.　Conclusion　TheprevalenceoflungdiseasesishighinpatientswithPM,DMandADM.ILDisthemainpulmonaryinvolvement,andfever,olderageatonset,hypoalbuminemia,highervaluesofbloodsedimentation,RaynaudphenomenonandarthritisorarthralgiawerethepredictivefactorsfordevelopingILD.PatientswithacuteILDhavepoorprognosis.Deathcasesoftenhavepulmonaryinfections.
%K 多发性肌炎
%K 皮肌炎
%K 无肌病性皮肌炎
%K 并发症
%K 肺疾病
%U http://www.hxyxqk.com.cn/oa/DArticle.aspx?type=view&id=201105002