Clinical characteristics and risk factors for death in anti-MDA5 positive dermatomyositis patients
Objective To analyze the clinical characteristics and risk factors for death in patients with anti-melanoma differentiation-associated gene 5 positive dermatomyositis.Methods The clinical data of 67 dermatomyositis patients admitted to the Department of Rheumatology and Immunology between August 2017 and August 2022 was retrospectively analyzed,including 34 MDA5 positive dermatomyositis patients(positive group)and 33 MDA5 negative ones(control group),and their clinical characteristics were analyzed.According to the clinical outcomes of patients,the MDA5 positive group was again divided into a death group(8 cases)and a survival group(26 cases)before the risk factors for death were analyzed.Results Among the 67 patients with dermatomyositis,34 were in the positive group and 33 in the control group,with an average age of 52.00(20.00,85.00)years.Compared with the control group,the positive group was more vulnerable to arthritis(x2=6.594,P=0.010),characteristic rash(x2=12.653,P＜0.001)and interstitial lung disease(x2=4.422,P=0.035).White blood cell levels(t=3.353,P=0.001),lymphocyte levels(t=2.970,P=0.004),total cholesterol levels(t=2.625,P=0.011),low density lipoprotein cholesterol levels(t=4.029,P＜0.001)and C3 decreased(t=4.536,P=0.033).However,the levels of alanine aminotransferase(t=2.202,P=0.028),aspartate aminotransferase(t=2.772,P=0.006),andy-glutamyltransferase(t-4.304,P＜0.001),and the rate of erythrocyte sedimentation(t=5.235,P=0.022)were higher,so was IL-6(t=8.232,P=0.004),and the differences were statistically significant.Multivariate logistic regression analysis showed that lymphocytes＜0.55X109/L(OR=31.403,95％CI:1.648～598.438),interleukin-6＞30 pg/m(OR=35.313,95％CI:1.526～817.279),and ferritin＞1 100 μg/L(OR=24.323,95％CI:1.309～452.038)were risk factors for death.Conclusion MDA5 positive patients with dermatomyositis are more susceptible to arthritis,characteristic rash and interstitial lung disease,with high inflammatory markers and high mortality.
万方数据
维普
