北京大学学报（医学版）2024，Vol.56Issue(2)：284-292,9.DOI:10.19723/j.issn.1671-167X.2024.02.013
特发性炎性肌病完全临床应答相关因素的单中心真实世界研究
A unicenter real-world study of the correlation factors for complete clinical response in idiopathic inflammatory myopathies
赖展鸿 1李依敏 2李玉慧 1栗占国 1李嘉辰 1贠泽霖 1张永刚 3张昊 4邢晓燕 1邵苗 1金月波 1王乃迪1
作者信息
- 1. 北京大学人民医院风湿免疫科,北京 100044
- 2. 浙江大学医学院附属第一医院风湿免疫科,杭州 310003
- 3. 保定市第一中心医院风湿免疫科,河北保定 071000
- 4. 大连市中心医院风湿免疫科,辽宁大连 116089
- 折叠
摘要
Abstract
Objective:To investigate the correlation factors of complete clinical response in idiopathic inflammatory myopathies(IIMs)patients receiving conventional treatment.Methods:Patients diagnosed with IIMs hospitalized in Peking University People's Hospital from January 2000 to June 2023 were in-cluded.The correlation factors of complete clinical response to conventional treatment were identified by analyzing the clinical characteristics,laboratory features,peripheral blood lymphocytes,immunological indicators,and therapeutic drugs.Results:Among the 635 patients included,518 patients finished the follow-up,with an average time of 36.8 months.The total complete clinical response rate of IIMs was 50.0％(259/518).The complete clinical response rate of dermatomyositis(DM),anti-synthetase syn-drome(ASS)and immune-mediated necrotizing myopathy(IMNM)were 53.5％,48.9％and 39.0％,respectively.Fever(P=0.002)and rapid progressive interstitial lung disease(RP-ILD)(P=0.014)were observed much more frequently in non-complete clinical response group than in complete clinical re-sponse group.The aspartate transaminase(AST),lactate dehydrogenase(LDH),D-dimer,erythrocyte sedimentation rate(ESR),C-reaction protein(CRP)and serum ferritin were significantly higher in non-complete clinical response group as compared with complete clinical response group.As for the treat-ment,the percentage of glucocorticoid received and intravenous immunoglobin(IVIG)were significantly higher in non-complete clinical response group than in complete clinical response group.Risk factor analysis showed that IMNM subtype(P=0.007),interstitial lung disease(ILD)(P=0.001),eleva-ted AST(P=0.012),elevated serum ferritin(P=0.016)and decreased count of CD4+T cells in peripheral blood(P=0.004)might be the risk factors for IIMs non-complete clinical response.Conclu-sion:The total complete clinical response rate of IIMs is low,especially for IMNM subtype.More effec-tive intervention should be administered to patients with ILD,elevated AST,elevated serum ferritin or decreased count of CD4+T cells at disease onset.关键词
特发性炎性肌病/临床应答/间质性肺病/危险因素/自身抗体Key words
Idiopathic inflammatory myopathies/Clinical response/Interstitial lung disease/Risk fac-tors/Autoantibodies分类
医药卫生引用本文复制引用
赖展鸿,李依敏,李玉慧,栗占国,李嘉辰,贠泽霖,张永刚,张昊,邢晓燕,邵苗,金月波,王乃迪..特发性炎性肌病完全临床应答相关因素的单中心真实世界研究[J].北京大学学报（医学版）,2024,56(2):284-292,9.
