Clinical characteristics and prognosis of anti-MDA5 antibody positive dermatomyositis pa-tients with secondary interstitial lung disease
Objective:To analyze the clinical characteristics and prognostic factors of anti-melanoma differentiation-associated gene 5(MDA5)-positive dermatomyositis(DM)patients with secondary interstitial lung disease(ILD).Methods:A retrospective collection was conducted on 97 patients with DM-ILD admitted to the First Affiliated Hospital of Guangxi Medical University from January 2018 to December 2022.They were di-vided into anti-MDA5 positive group and anti-MDA5 negative group.The clinical characteristics and survival rate of the two groups were compared,and the influencing factors of prognosis were analyzed.Results:Com-pared with the anti-MDA5 negative group,the disease duration of the anti-MDA5 positive group was shorter,the proportion of chest tightness,rapid progress(RP)-ILD,pulmonary infection and skin ulcers was increased,the proportion of pulmonary arterial hypertension(PAH)was decreased,the levels of white blood cells,platelets and creatine kinase were decreased,and the serum ferritin levels were increased(all P＜0.05).Compared with the anti-MDA5 negative group,the proportions of combination of two immunosuppressants,use of gamma globulin and the first use of antibiotics during hospitalization were higher in the anti-MDA5 positive group(all P＜0.05).With a median follow-up of 17.5 months,the overall mortality rate of anti-MDA5 positive group was 45.5%,and the 6-month,12-month and 36-month survival rates were 61.43%,58.57%and 55.71%,respectively.Cox regres-sion analysis showed that the risk factors for the prognosis of anti-MDA5 positive ILD were RP-ILD,Velcro rales and elevated carcinoembryonic antigen(CEA)(all P＜0.05).Conclusion:Patients with anti-MDA5 positive ILD have a shorter disease duration.They are prone to skin ulcers and lung infections,have a low incidence of PAH,and have a high proportion of immunosuppressive agents combination and antibiotic use.The occurrence of RP-ILD,Velcro rales,and elevated CEA are risk factors for prognosis.
万方数据
维普
