血清抗黑色素瘤分化相关基因5阳性皮肌炎胸部CT特征定性及定量分析
Qualitative and Quantitative Analysis of Chest CT Features of Anti-MDA5 Antibody Positive Dermatomyositis
王蕾 1徐妍妍 1黄振国 1任雁宏 2舒晓明 3刘敏1
作者信息
- 1. 中日友好医院放射诊断科,北京 100029
- 2. 中日友好医院呼吸与危重症科,北京 100029
- 3. 中日友好医院风湿与免疫科,北京 100029
- 折叠
摘要
目的 定性及定量分析血清抗黑色素瘤分化相关基因5(MDA-5)抗体阳性的皮肌炎患者胸部CT特征及其与短期预后的关系.资料与方法 回顾性纳入2017年 1月—2018年12月中日友好医院收治的67例MDA-5阳性的皮肌炎患者,分析胸部CT 特征与短期不良预后的关系.结果 9 例患者 1 年内死亡.死亡组与存活组间质性肺疾病(ILD)影像学类型(χ2=9.964,P=0.025)和肺动脉直径/主动脉直径比值(U=103.0,P=0.004)差异有统计学意义.抗MDA-5抗体阳性的皮肌炎患者合并ILD影像学类型主要为机化性肺炎.弥漫性肺泡损伤的患者死亡率显著高于其他几种类型.Logistic 回归分析显示,肺动脉直径/主动脉直径比值(OR 4.208,P=0.002)是抗MDA-5抗体阳性的皮肌炎合并ILD患者发生死亡的强独立危险因素.结论 MDA-5阳性皮肌炎患者大部分伴ILD,其中以机化性肺炎为主要特征.1 年内不良预后患者ILD类型不同,但肺动脉直径/主动脉直径比值是MDA-5 阳性皮肌炎合并ILD患者发生死亡的独立危险因素.
Abstract
Purpose To observe the CT imaging features of dermatomyosistis patients with anti-melanoma differentiation related genes 5(MDA-5),and to analyze the relationship between CT imaging indicators and short-term prognosis of patients.Materials and Methods Sixty-seven MDA-5-positive dermatomyosistis patients admitted to China-Japan Friendship Hospital from January 2017 to December 2018 were retrospectively included.Prognosis of included patients in one year were followed-up.Analysis of the relationship between chest CT imaging and short-term poor prognosis.Results Among 67 patients,nine patients died in one year.There was a statistically significant difference between the two groups(the death group and the survivor group)in the interstitial lung disease(ILD)imaging types(χ2=0.198,P=0.025)and pulmonary/aortic diameter ratios(U=103.0,P=0.004).CT imaging of dermatomyosistis-ILD with anti-MDA5 antibody positive patients showed organizing pneumonia.Mortality of diffuse alveolar damage type was significantly higher than that of other types.Logistic regression analysis showed that pulmonary/aortic diameter ratio(OR:4.208,P=0.002)was a strong independent risk factor for the death of patients with anti-MDA5 antibody.Conclusion Most patients with anti-MDA5 antibody positive dermatomyositis show ILD,with the main feature of organic pneumonia.Patients with poor prognosis within 1 year have different types of ILD,while the pulmonary/aortic diameter ratio is a strong independent risk factor for the death of dermatomyosistis-ILD with anti-MDA5 antibody positive patients.
关键词
抗黑色素瘤分化相关基因5抗体/皮肌炎/间质性肺疾病/体层摄影术,X线计算机Key words
Anti-melanoma differentiation related gene 5 antibody/Dermatomyosistis/Interstitial lung disease/Tomography,X-ray computed引用本文复制引用
基金项目
国家重点研发计划(2021YFC2500703)
出版年
2024
NETL
NSTL
万方数据