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华西医学  2015 

多发性肌炎/皮肌炎患者心脏损害的临床分析

DOI: 10.7507/1002-0179.20150463, PP. 1613-1617

Keywords: 多发性肌炎,皮肌炎,心脏病变,肺间质病变

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Abstract:

目的?回顾分析多发性肌炎(PM)和皮肌炎(DM)合并心脏病的发生率、临床特点及危险因素。方法?收集2008年1月-2014年3月138例PM/DM患者临床资料,其中PM78例,DM60例;男64例,女74例;平均年龄(48.5±19.6)岁;平均病程(84.5±6.9)个月。分析心脏病变的发生率、心脏损害的类型及其发病的危险因素,分别对年龄、性别、病程、病种、肌酸激酶(CK)、肌酸激酶同工酶MB(CK-MB)、CK-MB/CK、肌钙蛋白T、抗核抗体、抗SSA抗体、红细胞沉降率(血沉)、C反应蛋白(CRP)、疾病活动性评分、肌力、肺间质病变、肺动脉高压等临床资料作单因素和多因素分析。结果?138例患者中合并心脏病变59例(42.7%),48例(34.8%)存在异常心电图,52例(37.7%)心脏彩色多普勒超声异常;合并心脏病变的患者以心肌损害、心律失常、心肌缺血为主,9例(15.3%)死亡。单因素分析结果显示PM/DM合并心脏病变与年龄、病程、上肢肌力、疾病活动性评分、肺间质病变有关(P<0.05),随后纳入多因素logistic回归分析发现,病程(OR=1.669,P=0.010)、疾病总活动性评分(OR=7.456,P<0.001)、肺间质病变(OR=4.568,P=0.014)是PM/DM合并心脏病变的危险因素。结论?PM/DM患者中病程长、疾病活动度评分高、合并肺间质病变的患者更易出现心脏损害。

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