中华皮肤科杂志
中華皮膚科雜誌
중화피부과잡지
Chinese Journal of Dermatology
2009年
1期
19-21
,共3页
皮肌炎%Gottron疹%肺疾病,间质性%回顾性研究
皮肌炎%Gottron疹%肺疾病,間質性%迴顧性研究
피기염%Gottron진%폐질병,간질성%회고성연구
Dermatomyositis%Gottron exanthema%Lung diseases,interstitial%Retrospective studies
目的 探讨皮肌炎(DM)患者中Gottron皮疹与肺间质病变(ILD)的关系.方法 回顾分析83例皮肌炎患者的临床资料,根据有无Gottron皮疹分组,比较两组的临床特点.结果 DM患者Gottron皮疹的总阳性率为59%(49/83例),ILD的发生率为42.2%(35/83例),Gottron皮疹阳性组ILD的发生率明显低于Gottron皮疹阴性组,两者差异有统计学意义(24.5%比67.6%,P<0.01).35例ILD中Gottron皮疹阴性者的CO弥散率(DLCO)明显低于Gottron皮疹阳性者(60.9±13.5比72.3±12.7,P<0.05).Gottron皮疹阳性组与阴性组的肌力(4.0±0.9比3.8±1.2,P>0.05)、肌肉压痛(63.3%比70.6%,P>0.05)、肌酶水平(肌酸磷酸激酶1047.9±1402.7比1359.7±1752.4,乳酸脱氢酶397.2±226.5比402.4±197.0,AST97.6±98.0比120.1±82.3,P均>0.05)比较差异无统计学意义.两组的ESR、CRP水平比较差异亦无统计学意义(分别为26.5±16.4比33.3±25.3,11.9±8.3比15.5±9.8,P均>0.05).Gottmn皮疹阳性组与阴性组恶性肿瘤的发生率差异无统计学意义(21.4%比6.5%,P>0.05).结论 Gottron皮疹阳性的皮肌炎患者伴发肺间质病变的可能性小,且病变程度可能较轻.Gottron皮疹与DM的肌肉病变程度及病情活动无明显关系,Gottron皮疹可能与恶性肿瘤的发生无明显关系.
目的 探討皮肌炎(DM)患者中Gottron皮疹與肺間質病變(ILD)的關繫.方法 迴顧分析83例皮肌炎患者的臨床資料,根據有無Gottron皮疹分組,比較兩組的臨床特點.結果 DM患者Gottron皮疹的總暘性率為59%(49/83例),ILD的髮生率為42.2%(35/83例),Gottron皮疹暘性組ILD的髮生率明顯低于Gottron皮疹陰性組,兩者差異有統計學意義(24.5%比67.6%,P<0.01).35例ILD中Gottron皮疹陰性者的CO瀰散率(DLCO)明顯低于Gottron皮疹暘性者(60.9±13.5比72.3±12.7,P<0.05).Gottron皮疹暘性組與陰性組的肌力(4.0±0.9比3.8±1.2,P>0.05)、肌肉壓痛(63.3%比70.6%,P>0.05)、肌酶水平(肌痠燐痠激酶1047.9±1402.7比1359.7±1752.4,乳痠脫氫酶397.2±226.5比402.4±197.0,AST97.6±98.0比120.1±82.3,P均>0.05)比較差異無統計學意義.兩組的ESR、CRP水平比較差異亦無統計學意義(分彆為26.5±16.4比33.3±25.3,11.9±8.3比15.5±9.8,P均>0.05).Gottmn皮疹暘性組與陰性組噁性腫瘤的髮生率差異無統計學意義(21.4%比6.5%,P>0.05).結論 Gottron皮疹暘性的皮肌炎患者伴髮肺間質病變的可能性小,且病變程度可能較輕.Gottron皮疹與DM的肌肉病變程度及病情活動無明顯關繫,Gottron皮疹可能與噁性腫瘤的髮生無明顯關繫.
목적 탐토피기염(DM)환자중Gottron피진여폐간질병변(ILD)적관계.방법 회고분석83례피기염환자적림상자료,근거유무Gottron피진분조,비교량조적림상특점.결과 DM환자Gottron피진적총양성솔위59%(49/83례),ILD적발생솔위42.2%(35/83례),Gottron피진양성조ILD적발생솔명현저우Gottron피진음성조,량자차이유통계학의의(24.5%비67.6%,P<0.01).35례ILD중Gottron피진음성자적CO미산솔(DLCO)명현저우Gottron피진양성자(60.9±13.5비72.3±12.7,P<0.05).Gottron피진양성조여음성조적기력(4.0±0.9비3.8±1.2,P>0.05)、기육압통(63.3%비70.6%,P>0.05)、기매수평(기산린산격매1047.9±1402.7비1359.7±1752.4,유산탈경매397.2±226.5비402.4±197.0,AST97.6±98.0비120.1±82.3,P균>0.05)비교차이무통계학의의.량조적ESR、CRP수평비교차이역무통계학의의(분별위26.5±16.4비33.3±25.3,11.9±8.3비15.5±9.8,P균>0.05).Gottmn피진양성조여음성조악성종류적발생솔차이무통계학의의(21.4%비6.5%,P>0.05).결론 Gottron피진양성적피기염환자반발폐간질병변적가능성소,차병변정도가능교경.Gottron피진여DM적기육병변정도급병정활동무명현관계,Gottron피진가능여악성종류적발생무명현관계.
Objective To assess the relationship between Gottron papules and interstitial lung disease (ILD) in patients with dermatomyositis. Methods Clinical data were retrospectively collected from 83 patients with dermatomyositis (DM), who were classified into two groups based on the presence of Gottron papules. Results The prevalence of Gottron papules and ILD was 59.0% and 42.2%, respectively in these patients. A significant difference was observed in the incidence of ILD between patients with and without Gottron papules (24.5% vs 67.6%, P<0.01). In the patients with ILD, the average value of diffusing capacity of the lung for carbon monoxide (DLCO) in those without Gottron papules was significantly lower than that in those with Gottron papules (60.9±13.5 vs 72.3±12.7, t=2.427, P<0.05). No significant difference was observed between the patients with Gottron papules and those without in muscle strength (4.0±0.9 vs 3.8±1.2), the level of serum creatine phosphokinase (1047.9±1402.7 IU/L vs 1359.7±1752.4 IU/L), lactic acid dehydrogenase (397.2±226.5 IU/L vs 402.4±197.0 IU/L), aspartate aminotransferase (97.6±98.0 IU/L vs 120.1±82.3 IU/L),C reactive protein (11.9±8.3 mg/L vs 15.5±9.8 mg/L), erythrocyte sedimentation rate (26.5±16.4 mm/l h vs 33.3±25.3 mm/l h), the incidence of muscle tendemess (63.3% vs 70.6%) or malignant melanoma (21.4% vs 6.5%). Conclusions Patients presenting Gottron papules tend to show a decreased incidence and severity of ILD. No significant association was observed between the presence of Gottron papules and the degree of muscle changes or dermatomyositis activity, and the presence of Gottron papules seems to have no obvious relationship to the development of malignant melanoma.
