CAJ | 학술논문

目的研究PM/DM伴发静脉血栓栓塞(VTE)的临床特点及可能危险因素.方法回顾性分析2000年1月至2014年10月间北京协和医院收住院的成人PM/DM患者中伴发VTE者临床资料,采用t检验、x2检验进行数据分析.结果 PM/DM伴发VTE者23例,占同期住院PM/DM的1.86％(23/1 235).其中PM 5例,DM 18例;男性5例,女性18例.PM与DM之间发生静脉血栓栓塞的比例差异无统计学意义,男女之间发生静脉血栓栓塞的比例差异亦无统计学意义.23例VTE患者年龄47～71岁,平均(57±7)岁,比未发生血栓的PM/DM住院患者的平均年龄(47±13)岁大(t=-3.191,P=0.001).75％(21/28)的VTE发生在PM/DM确诊后的1年内.发生VTE者中,深静脉血栓(DVT) 18例(占1.46％,18/1 235);肺血栓栓塞(PTE)9例(占0.73％,9/1235),其中合并下肢DVT者4例.发生VTE时PM/DM病情多有活动和血浆D-二聚体的升高.结论 PM/DM患者存在发生VTE的风险,特别是年龄偏大患者,且可能多在PM/DM诊断后的早期发生,临床应提高认识,及早筛查并干预.
목적 연구PM/DM반발정맥혈전전새(VTE)적림상특점급가능위험인소.방법 회고성분석2000년1월지2014년10월간북경협화의원수주원적성인PM/DM환자중반발VTE자림상자료,채용t검험、x2검험진행수거분석.결과 PM/DM반발VTE자23례,점동기주원PM/DM적1.86％(23/1 235).기중PM 5례,DM 18례;남성5례,녀성18례.PM여DM지간발생정맥혈전전새적비례차이무통계학의의,남녀지간발생정맥혈전전새적비례차이역무통계학의의.23례VTE환자년령47～71세,평균(57±7)세,비미발생혈전적PM/DM주원환자적평균년령(47±13)세대(t=-3.191,P=0.001).75％(21/28)적VTE발생재PM/DM학진후적1년내.발생VTE자중,심정맥혈전(DVT) 18례(점1.46％,18/1 235);폐혈전전새(PTE)9례(점0.73％,9/1235),기중합병하지DVT자4례.발생VTE시PM/DM병정다유활동화혈장D-이취체적승고.결론 PM/DM환자존재발생VTE적풍험,특별시년령편대환자,차가능다재PM/DM진단후적조기발생,림상응제고인식,급조사사병간예.
Objective To investigate the clinical characteristics of polymyositis/dermatomyositis (PM/DM) complicated with venous thromboembolism (VTE).Methods Medical records of patients with PM/DM at Peking Union Medical College Hospital from Jan 2000 to Oct 2014 were reviewed to identify VTE.The comparisons of various categorical clinical manifestations between groups were evaluated using t-test and x2 test.Results Twenty-three PM/DM patients developed VTE,which accounted for 1.86％ of the 1 235 PM/DM patients hospitalized during the same period.Among these 23 patients (18 female and 5 male),5 patients had PM and 18 patients had DM.With respect to the occurrence of VTE,no significant difference was found between DM and PM or between male and female.Their age was (57±7) years (range:47-71 years old),significantly older than patients without thrombosis [(47±13) years,t=-3.191,P=0.001].Twenty-one patients (75％,21/28) developed VTE in the first year after the diagnosis of PM/DM.The incidence rate ratios (IRR) for DVT in PM/DM were 1.46％ (18/1 235) and for PTE was 0.73％ (9/1 235),in which 4 cases complicated with lower extremity DVT.Most patients exhibited active disease and high levels of D-Dimer during the emergence of VTE.Conclusion Patients with PM/DM have an increased risk of VTE,especially in older patients and at the early stage after the diagnosis of PM/DM,indicating that more attention should be paid to these patients in the clinic.