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| 抗MDA5抗体阳性老年皮肌炎患者的临床特征分析 |
| The clinical characteristics of elderly dermatomyositis patients with positive anti-MDA5 antibody |
| 投稿时间：2021-07-19 |
| DOI：10.3969/j.issn.1000-0399.2022.03.011 |
| 中文关键词: 皮肌炎 抗MDA5抗体 老年人 临床特征 |
| 英文关键词: Dermatomyositis Anti-MDA5 antibody The elderly Clinical features |
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| 中文摘要: |
| 目的 探讨抗黑色素瘤分化相关基因5(MDA5)抗体阳性老年皮肌炎(DM)患者的临床特征及预后。方法 选取2014年12月至2021年5月南京医科大学炎性肌病及混合性结缔组织病相关间质性肺病专病联盟组织结构收集诊治的抗MDA5抗体阳性DM患者246例,根据年龄分为中青年(<60岁)组(n=169)与老年(≥60岁)组(n=77),分析两组患者的一般临床资料、实验室检查和影像学检查结果,比较两组患者临床特征、急进性间质性肺病(RP-ILD)发生率及死亡情况的差异。结果 老年组患者皮疹发生率(88.31%)低于中青年组(95.27%),差异有统计学意义(P<0.05);老年组患者血沉、C反应蛋白、血清铁蛋白、抗Ro-52抗体等均高于中青年组,差异均有统计学意义(P<0.05);老年组患者RP-ILD发生率(49.35%)高于中青年组(29.59%),死亡率(38.96%)高于中青年组(17.75%),差异均有统计学意义(P<0.05),但生存持续时间差异无统计学意义(P>0.05)。结论 抗MDA5抗体阳性的老年DM患者,皮疹发生率低,炎性指标、抗Ro-52抗体阳性率、RP-ILD发生率及死亡率高,起病更隐匿、预后更差。 |
| 英文摘要: |
| Objective To investigate the clinical characteristics and prognosis of elderly dermatomyositis (DM) patients with positiveanti-melanoma differentiation associated gene 5 (MDA5) antibody. Methods A total of 246 anti-MDA5 antibody-positive DM patients who were diagnosed and treated by Organizational Structure of Nanjing Medical University Inflammatory Myopathy and CTD-related ILD Special Disease Alliance from December 2014 to May 2021 were selectedand divided into young and middle-aged (<60 years old) group (n=169) and elderly (≥60 years old) group (n=77) according to age. The general clinical data, laboratory examination and imaging examination results of the two groups of patients were analyzed, and the differences in clinical characteristics, the incidence of rapidly progressive interstitial lung disease (RP-ILD) and the mortality were compared between the two groups. Results The incidence of rash in the elderly group was lower than that in the young and middle-aged group, and the difference was statistically significant(88.31% vs 95.27%, P<0.05). The erythrocyte sedimentation rate, C-reactive protein, serum ferritin,and anti-Ro52 antibody in the elderly group were higher than those in the young and middle-aged group, and the differences were statistically significant(P<0.05).The incidence rate of RP-ILD in the elderly groupwas higher than that in the young and middle-aged group(49.35% vs 29.59%), and the mortality rate was higher than that in the young and middle-aged group(38.96% vs 17.75%), and the differences were statistically significant(P<0.05). However, the difference in survival duration was not statistically significant (P>0.05). Conclusions The elderly DM patients with positive anti-MDA5 antibody have low incidence of rash, high incidence of inflammatory indicators, positive rate of anti-Ro52 antibody, RP-ILD and mortality.The onset is more insidious and the prognosis is worse. |
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