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目的探讨皮肌炎/多发性肌炎(DM/PM)合并肺间质病变(ILD)的临床特点。方法对80例DM/PM患者以及34例特发性肺纤维化(IPF)患者进行回顾性分析,对比DM/PM合并ILD及IPF患者的临床特点,并将DM/PM患者按合并及未合并ILD分成两组对临床症状和实验室检查结果进行比较。结果80例DM/PM患者中,合并ILD38例,ILD的发生率为47.5%。DM/PM合并ILD比IPF发病年龄轻,IPF老年男性患者多、且临床症状和体征更多见。影像学上,DM/PM合并ILD患者较多出现胸膜增厚。对于合并ILD的DM/PM患者与未合并者比较,关节痛及吞咽困难的比例、血沉、血清LDH、抗Jo-1抗体阳性率等指标在两组间有统计学差异(P<0.05)。38例合并ILD患者好转24例,无明显变化7例,死亡7例。结论ILD在DM或PM中发病率较高、症状不典型,应常规行肺部高分辨率CT(HRCT)检查。
Objective To investigate the clinical features of dermatomyositis / polymyositis (DM / PM) combined with interstitial lung disease (ILD). Methods 80 patients with DM / PM and 34 patients with idiopathic pulmonary fibrosis (IPF) were retrospectively analyzed. The clinical features of patients with DM / PM combined with ILD and IPF were compared. The DM / PM patients were merged and not merged The ILD was divided into two groups to compare clinical symptoms and laboratory findings. Results Among the 80 DM / PM patients, 38 cases were complicated with ILD and the incidence of ILD was 47.5%. DM / PM combined with ILD than IPF age of onset, IPF older men more patients, and clinical symptoms and signs more common. Imaging, pleural thickening in patients with DM / PM combined ILD more. There was a significant difference between the two groups in the indexes of arthritis and dysphagia, erythrocyte sedimentation rate, serum LDH, the anti-Jo-1 antibody positive rate in DM / PM patients with combined ILD and non-merger patients. Thirty-eight patients with ILD improved in 24 cases, with no significant change in 7 cases and 7 deaths. Conclusion The incidence of ILD in DM or PM is high and the symptoms are not typical. High-resolution lung CT (HRCT) examination should be routinely performed.