中国实用内科杂志2025，Vol.45Issue(6)：515-521,7.DOI:10.19538/j.nk2025060111
多发性肌炎或皮肌炎并发间质性肺病预后因素分析
Analysis of prognostic factors in patients with polymyositis or dermatomyositis combined with interstitial lung disease
摘要
Abstract
Objective To investigate the relationship of blood cell ratios and inflammatory markers with the prognosis of interstitial lung disease associated with dermatomyositis or polymyositis(DM or PM-ILD).Methods A retrospective study was conducted to collect the clinical data of 86 patients with DM or PM-ILD at the Rheumatology and Immunology Department of the First Affiliated Hospital of Nanchang University between June 2018 and December 2020.Patients were divided into a remission group(n=29)and an exacerbation group(n=57).The classification was based on high-resolution computed tomography(HRCT)findings and the international consensus statement on idiopathic pulmonary fibrosis by the American Thoracic Society(ATS)and the European Respiratory Society(ERS).Demographic characteristics,clinical symptoms and laboratory results were compared between the two groups.Results The exacerbation group had higher levels of erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),ferritin(SF),mean platelet volume to lymphocyte ratio(MPVLR),monocyte to lymphocyte ratio(MLR),and platelet to lymphocyte ratio(PLR)than the remission group(P＜0.001).In contrast,lymphocyte levels,monocyte levels,forced vital capacity(FVC),and diffusing capacity for carbon monoxide(DLCO)were lower in the exacerbation group(P＜0.05).The correlation analysis results indicated that PLR was significantly positively correlated with ESR(r=0.424,P＜0.01),CRP(r=0.421,P＜0.01),and SF(r=0.264,P=0.014).MPVLR also showed a significant positive correlation with ESR(r=0.288,P=0.007),CRP(r=0.338,P＜0.01),and SF(r=0.265,P=0.014).Additionally,MLR was significantly positively correlated with SF(r=0.284,P＜0.01).Among the pulmonary function-related indicators,PLR,MPVLR,and SF were significantly negatively correlated with DLCO％(r=-0.397,P＜0.01;r=-0.216,P=0.046;r=-0.440,P＜0.01).Meanwhile,SF was significantly negatively correlated with both FVC％and DLCO％(r=-0.440,P＜0.01;r=-0.296,P＜0.01).Multivariate logistic regression analysis revealed that higher levels of PLR,MPVLR and SF,along with reduced lymphocyte levels,were independent risk factors for DM or PM-ILD exacerbation.Conclusion PLR,MPVLR and SF levels are simple and effective indicators for predicting pulmonary prognosis in patients with DM or PM-ILD.关键词
皮肌炎/多发性肌炎/间质性肺病/肺功能/铁蛋白/预后Key words
dermatomyositis/polymyositis/interstitial lung disease/pulmonary function/ferritin/prognosis分类
医药卫生引用本文复制引用
李建斌,吕梦娜,刘鹏程,陈丽明,吴锐..多发性肌炎或皮肌炎并发间质性肺病预后因素分析[J].中国实用内科杂志,2025,45(6):515-521,7.基金项目
国家自然科学基金(82260898) （82260898）
