摘要
目的回顾分析多发性肌炎(PM)和皮肌炎(DM)合并心脏病的发生率、临床特点及危险因素。方法收集2008年1月-2014年3月138例PM/DM患者临床资料,其中PM 78例,DM 60例;男64例,女74例;平均年龄(48.5±19.6)岁;平均病程(84.5±6.9)个月。分析心脏病变的发生率、心脏损害的类型及其发病的危险因素,分别对年龄、性别、病程、病种、肌酸激酶(CK)、肌酸激酶同工酶MB(CK-MB)、CK-MB/CK、肌钙蛋白T、抗核抗体、抗SSA抗体、红细胞沉降率(血沉)、C反应蛋白(CRP)、疾病活动性评分、肌力、肺间质病变、肺动脉高压等临床资料作单因素和多因素分析。结果 138例患者中合并心脏病变59例(42.7%),48例(34.8%)存在异常心电图,52例(37.7%)心脏彩色多普勒超声异常;合并心脏病变的患者以心肌损害、心律失常、心肌缺血为主,9例(15.3%)死亡。单因素分析结果显示PM/DM合并心脏病变与年龄、病程、上肢肌力、疾病活动性评分、肺间质病变有关(P<0.05),随后纳入多因素logistic回归分析发现,病程(OR=1.669,P=0.010)、疾病总活动性评分(OR=7.456,P<0.001)、肺间质病变(OR=4.568,P=0.014)是PM/DM合并心脏病变的危险因素。结论 PM/DM患者中病程长、疾病活动度评分高、合并肺间质病变的患者更易出现心脏损害。
Objective To analyze the incidence of heart disease, its clinical manifestations and risk factors in patients with polymyositis （PM） and dermatomyositis （DM）. Methods We collected the clinical data of 138 PM （n=78） and DM （n=60） patients treated between January 2008 and March 2014, among whom there were 64 males and 74 females with an average age of （48.5±19.6） years old, and an average disease course of （84.5±6.9） months. We analyzed their incidence of heart disease, its clinical manifestations and the risk factors. Subsequently, we adopted single-factor analysis to analyze such factors as age, gender, disease course, kinds of disease, creatine kinase （CK）, CK-MB, CK-MB/ CK, troponin T, antinuclear antibodies, anti-SSA antibody, erythrocyte sedimentation rate, C-reactive protein, disease activity score, muscle force, pulmonary interstitial lesions and pulmonary artery hypertension. Results There were 59 （42.7%） patients with heart disease, 48 （34.8%） with abnormal electrocardiogram, and 52 （37.7%） with abnormal color Doppler ultrasound results. Logistics multiple factors regression analysis found that the course of the disease （OR= 1.669, P=0.010）, myositis disease activity score （OR=7.456, P 〈 0.001）, pulmonary interstitial lesions （OR=4.568, P=0.014） were risk factor for heart disease in PM/DM patients. Conclusion Long disease course duration, high myositis activity score and pulmonary interstitial lesions are strong predictors for heart damage in PM/DM patients.
出处
《华西医学》
CAS
2015年第9期1613-1617,共5页
West China Medical Journal
关键词
多发性肌炎
皮肌炎
心脏病变
肺间质病变
Polymyositis
Dermatomyositis
Heart disease
Interstitial lung disease
