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目的提高临床医生对抗Jo-1抗体阳性多发性肌炎(PM)或皮肌炎(DM)患者肺部受累影像学的认识,提高诊断水平,准确评估预后。方法对四川大学华西医院2007年12月至2013年7月21例抗Jo-1抗体阳性PM/DM患者的临床表现、实验室检查、影像学结果进行回顾性分析。结果抗Jo-1抗体阳性PM/DM患者绝大多数(80.95%)具备典型肺间质性病变表现,胸部影像学主要为磨玻璃影以及网格影;比较抗Jo-1抗体阴性PM/DM患者而言,抗Jo-1抗体阳性患者出现肺间质性病变的几率更高(P<0.05);伴有继发性间质性肺病是PM/DM预后不良的主要危险因素;个别抗Jo-1抗体阳性PM/DM患者会以肺部表现为首发症状,表现形式类似肺炎。结论抗Jo-1抗体阳性PM/DM患者常常并发继发性肺间质病变,多数患者影像学上表现符合间质性肺炎特征,个别表现类似肺炎。提高临床医生对此类疾病的认识,提高诊断水平,有助于判断预后。
OBJECTIVE: To improve the clinicians’ understanding of pulmonary involvement imaging in patients with Jo-1 antibody-positive polymyositis (PM) or dermatomyositis (DM), to improve the diagnostic level and accurately evaluate the prognosis. Methods The clinical manifestations, laboratory tests and imaging findings of 21 anti-Jo-1 antibody positive PM / DM patients in West China Hospital of Sichuan University from December 2007 to July 2013 were retrospectively analyzed. RESULTS: The majority of anti-Jo-1 antibody positive PM / DM patients (80.95%) had typical pulmonary interstitial lesions. The chest radiographs were mainly glass shadows and grids. Compared with anti-Jo-1 antibody negative PM / DM Patients with anti-Jo-1 antibody-positive patients have a higher risk of pulmonary interstitial lung disease (P <0.05); associated with interstitial lung disease is the main risk factor for PM / DM poor prognosis; individual anti-Jo -1 antibody positive PM / DM patients with pulmonary manifestations as the first symptom, the performance of similar pneumonia. Conclusion Anti-Jo-1 antibody-positive PM / DM patients often complicated by secondary interstitial lung disease, most patients with imaging findings consistent with the characteristics of interstitial pneumonia, individual performance is similar to pneumonia. Improve clinicians awareness of such diseases, improve the level of diagnosis, help to determine the prognosis.