皮肌炎合并问质性肺疾病20例临床分析

《皮肌炎合并问质性肺疾病20例临床分析》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。

1、•论著•皮肌炎合并间质性肺疾病20例临床分析李如林腎焦红梅刘斯民【廉要】目的探讨皮HI炎（DM）令并间质性肺疾病（ILD）的临床特点。方法回顾性分析20例DM合并ILD患者的临床资料。结果169例DM中合并ILD者20例，发病率为11.8%,4例无呼吸系统症状°11例血淸肌飯激的升馮.4例抗JoJ抗体阳性。胸部奇分辨率CT主妾龙現为磨玻承影、小叶间隔堆厚和不规则线状、网格影。肺功能以限制性通气功能障埒和弥敢功能下降为屯,15例患苕存住不同程度的低讯血症或呼吸衰竭:，经牺皮质激素和（或）免疫抑制剂治疗后，14例患者病悄明E好转,2例无缓解,4例死亡。结论DM合并1LD发生率庇，病死率

2、高，临床易漏诊，应提高对本病的认讥,早诊断早治疗，最大程度改善电者的预后。【关键词】皮肌炎；肺疾病•间质性Aclinicalanalysisofdermatomyositiswithintcrstituillungdiseasein20patientsUHongJJNQing.JIAOHnng-mei%IJUAin-zruaDcpartmeniofGeriatrictPekingUniwrsUyFirstHospiuiltBeijing100034,ChinaComspondingauthor:fJHung.EmailJih7510@163.corn(lAbstrael]Objec

3、tiveToinvestigalctheclinics】featumsofthepatientswithdcimatoniyositis{DM)coinpliuaUMiwilhintestinallungdisease(ILD).MethodsTheclinicalmanifestaliorwarwlthelaUnatorydatau(the20patientswithDMcomplicatedwithILDwererctroBpcctivclyanalyzed.ResultsAmong169DMpatienU920(11.8%)werefoundedwithILDand4hadn

4、ocomplainlofrespiratorysy&tem.TlieratioofmaleIofemalewas1-2.33.Thelevelofscrumercadnekinase(CK)waselevatedin11cases.Anti-Jo-1antibodywaspositivein4cases.Bilateralinfiltratesiincludingground-gbhwattenuation,interlobularseptalthickeningandreticularopacitiesweretburwlbychesthighresolutioncomputed

5、tfimngraphy-Theimpairmentoflungfunctionwasmanifestedasthedecreaseddiffusioncapacityforcarbonmonoxideofdielung(D

6、CO)andrestrictedveniilatoryfunctiondbnuniuiliues.Fifteencase$shnwedhypoxemiaorrespiratoryFailurebyarterialbloodgasanalysis.Allpatientsweretreatedwithglucocorticoidand/wimniuixjsuppre

7、s^iveagents.Totallyt14patientsFiadimprowoti.while2pulienU“ihnoimprovementand4patientsdiedwithamortalityof20%.ConclusionsDMcomplicatedwithILDwhichiseasilymissedha皆ahighmorbidityandmortality・TheunderstandingDMcomplicatedwithTLDshouldbeenhanced,thufwearlydiagnosisandinterventioncouldbeperiurmwlfo

8、rbetterpnxgnosis.[Keywords]I>ermaromyosih5；Lungdisease.interstitial皮肌炎（DM）是一种以横纹肌受累为主同时伴有皮肤损寓的自身免疫性炎性肌病，主要持征为肢体近端、颈部及疔咽肌等肌肉组织发生炎性改变,岀现肌无力和肌痛症状°DM常累及多个系统，肺部是最常受累的器官之一,间质性肺疾病（【LD）是DM常见的重症并发症，其发病率高达10%~60%山。合并ILD的DM患者病悄垂，治疗困难，预后差，病死率高。本研究回