CAJ | 학술논문

目的分析成人多发性肌炎(PM)和(或)皮肌炎(DM)主要器官损害的发生率和特点,并确定与其相关的特异性因素.方法使用统一的调查表,回顾性收集2007至2012年在全国22个三级甲等医院风湿免疫科住院的符合纳入排除标准的1 387例成人PM和(或)DM患者的病例资料,并进行统计分析.结果共收集1 387例患者,其中PM 460例(33.2％)和DM 927例(66.8％),女∶男=2.4∶1.发病年龄(47±14)岁.其中1 031例(74.3％)出现器官损害.肺部损害(44.6％)发生率最高,其次是关节炎(32.3％)、消化道损害(21.9％)及心脏损害(20.3％).多因素回归分析显示,肺部损害与年龄≥40岁(P＜0.01)正相关,与肌痛(P＜0.05)负相关.关节炎与发热(P＜0.05)、体重下降(P＜0.05)及雷诺现象(P＜0.01)正相关,与肌无力(P＜0.05)负相关.消化道损害与体重下降(P＜0.05)、雷诺现象(P＜0.01)和肌无力(P＜0.05)正相关.心脏损害与体重下降(P＜0.05)及四肢肿胀(P＜0.05)正相关.结论成人PM和(或)DM器官损害发生率高,本研究结果有助于尽早发现其器官损害.
목적 분석성인다발성기염(PM)화(혹)피기염(DM)주요기관손해적발생솔화특점,병학정여기상관적특이성인소.방법 사용통일적조사표,회고성수집2007지2012년재전국22개삼급갑등의원풍습면역과주원적부합납입배제표준적1 387례성인PM화(혹)DM환자적병례자료,병진행통계분석.결과 공수집1 387례환자,기중PM 460례(33.2％)화DM 927례(66.8％),녀∶남=2.4∶1.발병년령(47±14)세.기중1 031례(74.3％)출현기관손해.폐부손해(44.6％)발생솔최고,기차시관절염(32.3％)、소화도손해(21.9％)급심장손해(20.3％).다인소회귀분석현시,폐부손해여년령≥40세(P＜0.01)정상관,여기통(P＜0.05)부상관.관절염여발열(P＜0.05)、체중하강(P＜0.05)급뢰낙현상(P＜0.01)정상관,여기무력(P＜0.05)부상관.소화도손해여체중하강(P＜0.05)、뢰낙현상(P＜0.01)화기무력(P＜0.05)정상관.심장손해여체중하강(P＜0.05)급사지종창(P＜0.05)정상관.결론 성인PM화(혹)DM기관손해발생솔고,본연구결과유조우진조발현기기관손해.
Objective To explore the prevalence and characteristics of main organ involvement in adult patients with polymyositis (PM) or dermatomyositis (DM) and determine their specific relative factors.Methods Using unified questionnaire,we retrospectively collected the medical records of 1 387 confirmed adult PM/DM patients from 2007 to 2012 at 22 rheumatology centers in China.Statistical analyses were performed with chi-square or Fisher exact test and multivariate analyses with logistic regression.Results A total of 1 387 patients were collected with 460 (33.2％) PM and 927 (66.8％) DM.The female:male ratio was 2.4∶ 1.Their onset age was(47 ± 14) years.A total of 1 031 (74.3％) patients had organ involvement.The prevalence of pulmonary involvement,arthritis,gastrointestinal and cardiac involvement were 44.6％,32.3％,21.9％ and 20.3％ respectively.The multivariate analysis indicated that older onset age (P ＜ 0.01) was positively associated with pulmonary involvement while myalgia (P ＜0.05) was negatively associated.Fever (P ＜ 0.05),weight loss (P ＜ 0.05) and Raynaud's phenomenon (P ＜ 0.01) were positively associated with arthritis while muscle weakness (P ＜ 0.05) negatively associated.Weight loss (P ＜0.05),Raynaud's phenomenon (P ＜0.01) and muscle weakness (P ＜0.05)were positively associated with gastrointestinal involvement.Weight loss (P ＜ 0.05) and swollen limbs (P ＜0.05) were positively associated with cardiac involvement.Conclusion The prevalence of organ involvement is high in adult PM/DM patients.Our study may aid the diagnosis of organ damage in PM/DM patients.