CAJ | 학술논문

目的探讨皮肌炎(DM)伴发肺间质病变(ILD)的临床特点及其相关因素.方法回顾分析复旦大学附属华山医院皮肤科近6年来收治的206例DM患者临床资料,采用x2检验、t检验等分析DM伴发ILD的影响因素.结果 DM患者ILD的发生率为49.03％.上眼睑红斑、Gottron征、关节痛、咳嗽等临床表现均为DM伴发ILD的相关因素(P值均＜0.05),其中咳嗽、关节痛与ILD的发生率呈正相关,而Gottron征与ILD的发生率呈负相关.DM伴发ILD患者乳酸脱氢酶、羟丁酸脱氢酶、抗Jo-1抗体等实验室指标异常发生率显著高于DM不伴发ILD的患者(P值均＜0.05).DM伴发ILD患者肺功能较DM不伴发ILD患者显著下降(P＜0.05),其肺部CT表现主要为肺尖/肺底部的条索影(57.4％)、高密度斑片影(31.7％)、网格影(16.8％)、磨砂玻璃影(13.8％).结论 DM患者关节痛、咳嗽症状的发生率与ILD呈正相关,而Gottron征的发生率与ILD的伴发率呈负相关.DM伴发ILD患者肺部CT特征性表现为肺尖/肺底部条索影、斑片影、磨玻璃影和网格影.
목적 탐토피기염(DM)반발폐간질병변(ILD)적림상특점급기상관인소.방법 회고분석복단대학부속화산의원피부과근6년래수치적206례DM환자림상자료,채용x2검험、t검험등분석DM반발ILD적영향인소.결과 DM환자ILD적발생솔위49.03％.상안검홍반、Gottron정、관절통、해수등림상표현균위DM반발ILD적상관인소(P치균＜0.05),기중해수、관절통여ILD적발생솔정정상관,이Gottron정여ILD적발생솔정부상관.DM반발ILD환자유산탈경매、간정산탈경매、항Jo-1항체등실험실지표이상발생솔현저고우DM불반발ILD적환자(P치균＜0.05).DM반발ILD환자폐공능교DM불반발ILD환자현저하강(P＜0.05),기폐부CT표현주요위폐첨/폐저부적조색영(57.4％)、고밀도반편영(31.7％)、망격영(16.8％)、마사파리영(13.8％).결론 DM환자관절통、해수증상적발생솔여ILD정정상관,이Gottron정적발생솔여ILD적반발솔정부상관.DM반발ILD환자폐부CT특정성표현위폐첨/폐저부조색영、반편영、마파리영화망격영.
Objective To assess the clinical features and associated factors of interstitial lung disease (ILD) in patients with dermatomyositis (DM).Methods Clinical data were retrospectively analyzed on 206 patients with DM collected at the Department of Dermatology,Huashan Hospital,Fudan University in the past 6 years.Chi-square test and t test were performed for statistical analysis.Results The prevalence of ILD was 49.03％ in the 206 patients with DM.Heliotrope rash on the upper eyelids,Gottron's sign (papules),arthralgia,and cough were correlated with the incidence of ILD in DM patients (all P ＜ 0.05),and of these factors,the prevalence of artharalgia and cough were positively correlated with the incidence of ILD,while the presence of Gottron's papules was negatively correlated.The patients with DM and ILD showed a higher prevalence of abnormal serum levels of lactate dehydrogenase (LDH),hydroxybutyrate dehydrogenase (HBDH) and anti-Jo-1 antibodies,as well as with a poorer pulmonary function,compared with those suffering from DM only (all P ＜0.05).Characteristic imaging findings on computed tomography (CT) scan in patients with DM and ILD included linear opacity (57.4％),high-density patchy opacity (31.7％),reticular opacity (16.8％) and even ground glass-like opacity (13.8％),usually at the bottom or apex of the lungs.Conclusions In patients with DM,the prevalence of artharalgia and cough is positively correlated,whereas the presence of Gottron's papules is negatively correlated,with the incidence of ILD.Characteristic imaging findings on CT scan in patients with DM and ILD are linear opacity,high-density patchy opacity,reticular opacity and ground glass-like opacity at the bottom and apex of lungs.