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目的分析多发性肌炎(PM)/皮肌炎(DM)合并肺间质性病变(ILD)患者临床病理特征,为临床诊疗工作提供指导。方法 60例确诊的PM/DM、ILD患者,PM/DM伴ILD患者为A组(20例),PM/DM未合并ILD患者为B组(40例)。分析两组临床症状与实验室病理检查结果。结果 A组患者吞咽困难、关节痛、抗Jo-1抗体阳性例数均比B组多(P<0.05)。A组患者乳酸脱氢酶(LDH)、血沉(ESR)均比B组低(P<0.05)。A组经糖皮质激素治疗后肌酸激酶(CK)水平低于B组(P<0.05)。结论 PM/DM患者并发ILD几率较高,且无典型症状,常规肺部检查十分必要。不同病变情况患者CT检查可发现不同类型阴影。要警惕影像学检查胸膜增厚、原因不明的女性ILD患者PM/DM的发生。临床上要密切关注血沉快、关节痛、抗Jo-1抗体呈阳性、血清LDH上升等ILD典型预示性指标。
Objective To analyze the clinicopathological features of patients with polymyositis (PM) / dermatomyositis (DM) complicated with interstitial lung disease (ILD) and provide guidance for clinical diagnosis and treatment. Methods 60 patients with confirmed PM / DM, ILD, PM / DM with ILD were selected as group A (n = 20) and patients without PM / DM combined with ILD as group B (n = 40). Two groups of clinical symptoms and laboratory pathological examination results were analyzed. Results A group of patients with dysphagia, joint pain, anti-Jo-1 antibody positive cases were more than the B group (P <0.05). A group of patients with lactate dehydrogenase (LDH), ESR were lower than the B group (P <0.05). The level of creatine kinase (CK) in group A after glucocorticoid treatment was lower than that in group B (P <0.05). Conclusion PM / DM patients with high incidence of concurrent ILD, and no typical symptoms, routine lung examination is necessary. Different lesions of patients with CT examination can be found in different types of shadows. To guard against imaging studies pleural thickening, unexplained female patients with ILD PM / DM occurred. Clinically, we should pay close attention to ESR typical indicators of rapid ESR, joint pain, anti-Jo-1 antibody was positive, elevated serum LDH and other indicators of ILD.