CAJ | 학술논문

目的了解合并急性/亚急性间质性肺炎(A/SW)的皮肌炎患者临床特点及转归.方法工收集10例皮肌炎合并A/SIP患者(A/SIP组)临床资料,与同期收治的非A/SIP皮肌炎肺间质病变患者9例(非A/SIP组)进行对照,对患者生存率进行统计分析.结果与非A/SIP组相比,A/SIP组患者病程较短,发热、眶周红斑发生率较高,而血清肌酸激酶不高,胸部CT多数可见毛玻璃样改变(P＜0.01或＜0.05);A/SIP组患者生存率显著降低,至6个月时仅有1例存活(P=0.0001).Logistic回归分析显示,激素、环磷酰胺、环孢素联合治疗病死率较低,但差异无统计学意义(P=0.107).结论皮肌炎合并A/SIP病情进展快、病死率高,需要早期进行诊治.对于发病初期即出现胸闷气急,尤其伴有反复发热、眶周红斑而血清肌酸激酶不高的患者须警惕其发展为A/SIP.激素联合环磷酰胺、环孢素可能是较为有效的治疗方案.
목적 료해합병급성/아급성간질성폐염(A/SW)적피기염환자림상특점급전귀.방법 공수집10례피기염합병A/SIP환자(A/SIP조)림상자료,여동기수치적비A/SIP피기염폐간질병변환자9례(비A/SIP조)진행대조,대환자생존솔진행통계분석.결과 여비A/SIP조상비,A/SIP조환자병정교단,발열、광주홍반발생솔교고,이혈청기산격매불고,흉부CT다수가견모파리양개변(P＜0.01혹＜0.05);A/SIP조환자생존솔현저강저,지6개월시부유1례존활(P=0.0001).Logistic회귀분석현시,격소、배린선알、배포소연합치료병사솔교저,단차이무통계학의의(P=0.107).결론 피기염합병A/SIP병정진전쾌、병사솔고,수요조기진행진치.대우발병초기즉출현흉민기급,우기반유반복발열、광주홍반이혈청기산격매불고적환자수경척기발전위A/SIP.격소연합배린선알、배포소가능시교위유효적치료방안.
objecive To chrify clinical characteristics and outcme of acute/subacute interstitial pneumonia(A/SIP)in patients with dermatomyositis.Methods The elinical data of 10 dermatemyositis patients accompanied with A/SIP who hospitalized in April 2006 to April 2008 were reviewed.Data of 9 dermatomyesitis patients with non-A/SIP interstitial lung diseases treated during the same period were also documented for the comparison.The survival rate of patients wag statistically analyzed.Results Compared with those dermatomyositis patients with non-A/SIP interstitial lung diseases,patients with A/SIP had shorter disease courses and higher incidences of fever,heliotrope rash and ground glass opacity in CT image(P＜0.01or＜0.05).However,the levels of serum creatine kinase tended to be normal.After following up 6 months,only 1 patientwithA/SIP survived(P=0.0001).Logistic regression analysis showed the combination treatment of hormonal,cyclophosphamide and cyclosparine might prolong the survival time(P=0.107).Conclusions A/SIP with dermatomyositis is a fatal disease which needs to be early diagnosed and treated.Patients having dyspnea or breathless in the early stage,especially those with recurrent fever,heliotrope rash and normal serum creatine kinase is predicted to develop A/SIP later.A better outcome may be achieved when treating the patients with stemids plus cyclophosphamide and cyclosporine.