摘要
目的通过研究多发性肌炎(PM)和皮肌炎(DM)合并肺间质病变(ILD)患者的临床特点及其与抗Jo-1抗体的关系,探讨如何减少误诊和漏诊。方法回顾性对比分析抗Jo-1抗体阳性36例和阴性118例PM/DM患者,比较两组首发症状、临床及免疫学特征。结果抗Jo-1抗体阳性组以呼吸道症状首发者明显高于阴性组(52.8%vs 3.4%,P<0.05),伴发肺部感染、多关节炎、发热等症状多,RF阳性率较高,与抗R0-52、抗SSA/SSB相关性较强,检出率较高,易误诊或漏诊。部分PM/DM合并ILD患者仅有呼吸困难症状易误诊为心衰、特发性肺间质纤维化、肺部感染等疾病,而部分患者却因无相关呼吸系统症状而漏诊ILD。结论 PM/DM或肺间质性病变患者,均需积极完善包括抗Jo-1抗体的抗核抗体谱、肌酶谱的检测及高分辨螺旋CT、肺功能等检查,以减少误诊和漏诊。
Objective To investigate the clinical characteristics of polymyositis（PM）and dermatomyositis（DM）associated interstitial lung disease（ILD）and relationship with anti-jo-1 antibody,to explore how to reduce the misdiagnosis and missed. Methods Retrospective comparison and analysis of the first symptoms, clinical and immunologic features were performed between 36 PM/DM with anti-jo-1 antibody-positive patients and 118 patients with antibody-negative. Results The first symptom come from respiratory tract in antibody positive group was clearly higher than the negative group（52.8%vs3.4%,P〈0.05）, meanwhile, pulmonary infec tions, fever, arthritis, high RF positive rate, anti-R0-52 and anti-SSA/SSB were frequently seen in the positive group. For the above reason,PM/DM associated ILD were easily misdiagnosed or missed. For the more,part PM/DM associated ILD patients were misdiagnosed as heart failure, idiopathic pulmonary fibrosis, pulmonary infection and other diseases, because only had breathing difficulties. While,other part patients were missed ILD because of no related respiratory symptoms. Conclusion To reduce misdiagnosed and missed,PM/DM or ILD patients shoud be perfected examinationes including anti-jo-1 antibody,muscle enzymes of the assay, pulmonary function and thoracic high resolution spiral CT etc.
出处
《重庆医学》
CAS
CSCD
北大核心
2011年第19期1899-1900,1903,共3页
Chongqing medicine
关键词
多发性肌炎
皮肌炎
抗JO-1抗体
肺间质病变
poiymyositis
dermatomyositis
anti-jo-1 antibody
interstitial lung disease
