重庆医学2024,Vol.53Issue(14) :2182-2186.DOI:10.3969/j.issn.1671-8348.2024.14.020

92例IgG4相关性疾病患者的临床特征分析

Analyse of clinical characteristics of 92 patients with IgG4 related diseases

孙杰 钟艳艳 杨雪 于红云 徐晶 解见业 徐萍 温大蔚 赵磊 王吉波
重庆医学2024,Vol.53Issue(14) :2182-2186.DOI:10.3969/j.issn.1671-8348.2024.14.020

92例IgG4相关性疾病患者的临床特征分析

Analyse of clinical characteristics of 92 patients with IgG4 related diseases

孙杰 1钟艳艳 1杨雪 1于红云 1徐晶 1解见业 1徐萍 1温大蔚 2赵磊 2王吉波1
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作者信息

  • 1. 青岛大学附属医院全科医学科 山东青岛 266003
  • 2. 青岛大学附属医院风湿免疫科,山东青岛 266003
  • 折叠

摘要

目的 分析IgG4相关性疾病(IgG4-RD)的临床特点,指导治疗药物选择,探寻IgG4潜在的肿瘤标识意义.方法 通过医渡云系统择取2017年1月1日至2021年12月31日于该院住院治疗的92例IgG4-RD患者为研究对象,对其临床资料进行汇总分析,总结IgG4-RD的临床特点.结果 92例患者IgG4-RD确诊平均年龄为(58.1±11.3)岁,其中男65例(70.7%),女27例(29.3%).最常受累的器官组织为淋巴结(37例,40.2%)、胰腺(33例,35.9%)、唾液腺(31例,33.7%).92例患者中单器官组织受累者为28例(30.4%),双器官或多器官受累者各为32例(34.8%).92例患者中有89例患者接受激素治疗,71例患者接受免疫抑制剂治疗,其中45例使用过环磷酰胺(占63.4%).激素联合免疫抑制剂组的初始治疗有效率(72.7%vs.55.6%)与1年未复发率(38.2%vs.20.0%)均优于单用激素组,但差异无统计学意义(P>0.05).92例患者中肿瘤合并者IgG4水平>40 g/L的比例(18.2%)明显高于非肿瘤合并者(1.2%),差异有统计学意义(P<0.05),而其他IgG4水平分段中肿瘤合并者与非肿瘤合并者比较,患者比例差异无统计学意义(P>0.05).结论 IgG4-RD发病多见于中老年男性,淋巴结、胰腺、唾液腺受累者多见,多数患者双器官或多器官受累.治疗上建议激素与免疫抑制剂联合应用.IgG4-RD患者IgG4水平>40 g/L可能对并发肿瘤具有提示意义.

Abstract

Objective To analyze the clinical characteristics of IgG4-related disease (IgG4-RD),guide the selection of therapeutic drugs,and to explore the significance of potential tumor identification for IgG4-RD.Methods A total of 92 patients diagnosed with IgG4-RD and admitted to this hospital from January 1,2017 to December 31,2021were selected as the research subjects by using the Yidu Cloud system.The clinical data conducted the summary analysis. The clinical characteristics of IgG4-RD were summarized.Results The mean age of IgG4-RD was definitely diagnosed in the 92 patients was (58.1±11.3)years old,with 65 male ca-ses (70.7%) and 27 female cases (29.3%).The most commonly affected organ tissues were lymph nodes (37 cases,40.2%),pancreas (33 cases,35.9%) and salivary glands (31 cases,33.7%).In the patients woth the 92 patients,28 cases (30.4%) had involvement of a single organ tissue,while 32 cases (34.8%) had involvement of two or more organs.In the 92 patients,89 cases received steroid therapy,and 71 cases received immunosup-pressive therapy,in which 45 cases (63.4%) used cyclophosphamide.The initial treatment effective rate (72.7% vs. 55.6%) and one-year non-recurrence rate (38.2% vs. 20.0%) of the steroid combined immuno-suppressive therapy group were better than those of the single steroid group,but the differences were not sta-tistically significant (P>0.05).The proportion of the patients with tumor comorbidity and IgG4 level>40 g/L (18.2%) was significantly higher than that of the non-tumor comorbidity (1.2%),and the difference was statistically significant (P<0.05).However,there was no statistically significant difference in the proportion of patients with tumor comorbidity compared to the non-tumor comorbidity in other IgG4 level groups (P>0.05).Conclusion IgG4-RD is more common in middle-aged and elderly men,lymph nodes,pancreas and sal-ivary glands are commonly involved,and most patients have the double organs and multiple organs involve-ment. The combination use of hormone and immunosuppressant in treatment is recommended .The IgG4 lev-el>40 g/L in the patients with IgG4-RD may has the suggestive significance for complicating tumor.

关键词

IgG4相关疾病/受累器官/合并症/恶性肿瘤/治疗/IgG4水平

Key words

IgG4-related disease/affected organ/complications/malignant tumor/treatment/IgG4 level

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出版年

2024
重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
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