首页|高甘油三酯血症和抗黑色素瘤分化相关基因5抗体阳性皮肌炎相关间质性肺疾病的预后相关性研究

高甘油三酯血症和抗黑色素瘤分化相关基因5抗体阳性皮肌炎相关间质性肺疾病的预后相关性研究

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目的 观察血清甘油三酯(triglyceride,TG)与抗黑色素瘤分化相关基因5(melanoma differentiation-associated gene 5,MDA5)抗体阳性皮肌炎相关间质性肺疾病(interstitial lung disease,ILD)患者的预后相关性。方法 回顾性选择2017年2月一2021年7月在四川大学华西医院确诊为抗MDA5抗体阳性皮肌炎相关ILD的患者。收集患者的临床资料、实验室检查和影像学检查资料,并进行随访。根据生存和死亡状态,将患者分为生存组和死亡组。根据TG值,将患者分为TG高水平组和TG低水平组。采用Cox比例风险模型进行生存分析,以研究抗MDA5抗体阳性皮肌炎相关ILD患者的死亡相关因素。结果 共纳入抗MDA5抗体阳性皮肌炎相关ILD患者204例。其中,男性69例,女性135例;年龄30~81岁,平均(49。5±11。8)岁;死亡53例,存活151例;快速进展肺间质纤维化(rapidly progressive pulmonary interstitial lung disease,RPILD)57 例,非 RPILD 147 例。多因素Cox回归分析的结果表明,TG≥1。65 mmol/L、合并RPILD、合并呼吸困难、年龄、乳酸脱氢酶≥321 U/L、白蛋白<30 g/L是影响患者远期预后的独立因素(P<0。05)。Kaplan-Meier法分析结果显示,TG高水平组的生存率低于TG低水平组(P=0。032)。结论 TG升高可作为抗MDA5抗体阳性皮肌炎相关ILD患者不良预后的临床指标。此外,年龄、合并RPILD、合并呼吸困难、乳酸脱氢酶≥321 U/L、白蛋白<30 g/L是抗MDA5抗体阳性皮肌炎相关ILD患者死亡的独立危险因素。
Prognostic correlation between hypertriglyceridemia and anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis-associated interstitial lung disease
Objective To investigate the prognostic relevance of serum triglyceride(TG)levels in patients with anti-melanoma differentiation-associated gene 5(MDA5)antibody-positive dermatomyositis-associated interstitial lung disease(ILD).Methods A retrospective data collection was conducted on patients diagnosed with anti-MDA5 antibody-positive dermatomyositis-associated ILD at West China Hospital of Sichuan University between February 2017 and July 2021.The clinical data,laboratory tests,and imaging examinations were collected,and the patients were followed up.According to the survival and death status of patients,they were divided into survival group and death group.According to TG levels,the patients were divided into a TG high level group and a TG low level group.We employed Cox proportional hazard models to investigate the variables linked to the mortality of individuals afflicted with anti-MDA5 antibody-positive dermatomyositis-associated ILD.Results A total of 204 patients with anti-MDA5 antibody-positive dermatomyositis-associated ILD were included.Among them,whose age ranged from 30 to 81 years old,with an average of(49.5±11.8)years old,there were 69 males and 135 females,53 deaths and 151 survivors,57 cases of rapidly progressive pulmonary interstitial fibrosis(RPILD)and 47 cases of non-RPILD.The results of multivariate Cox regression analysis showed that TG≥ 1.65 mmol/L,combined with RPILD,combined with dyspnea,age,lactate dehydrogenase≥321 U/L,and albumin<30 g/L were independent factors affecting the long-term prognosis of patients(P<0.05).The Kaplan-Meier method analysis results showed that the survival rate of the TG high level group was lower than that of the TG low level group(P=0.032).Conclusions Elevated TG levels can serve as a clinical indicator of adverse prognosis in patients with dermatomyositis-associated ILD who exhibit positive anti-MDA5 antibody status.Additionally,age,comorbidity with RPILD,combined with dyspnea,lactate dehydrogenase≥321 U/L,and albumin<30 g/L are independent factors contributing to the increased mortality risk among individuals with dermatomyositis-associated ILD who test positive for anti-MDA5 antibody.

Triglycerideanti-melanoma differentiation-associated gene 5 antibodydermatomyositissurvival analysisinterstitial lung disease

李芊蔚、陈波、尹耕、谢其冰

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四川大学华西医院风湿免疫科(成都 610041)

甘油三酯 抗黑色素瘤分化相关基因5抗体 皮肌炎 生存分析 间质性肺疾病

四川大学华西医院学科卓越发展1·3·5工程项目四川大学华西医院临床研究孵化项目

ZYJC210242019HXFH038

2024

华西医学
四川大学华西医院

华西医学

CSTPCD
影响因子:0.744
ISSN:1002-0179
年,卷(期):2024.39(4)
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