摘要
目的探讨抗氨基酰tRNA合成酶(ARS)抗体阳性的多发性肌炎/皮肌炎(PM/DM)的临床特征。方法回顾性分析2014年9月至2017年11月我科诊断的PM/DM患者的临床资料,包括临床表现、实验室检查、影像学结果等。结果共诊断39例PM/DM患者,其中抗ARS抗体阳性者24例(包括抗Jo-1抗体阳性者14例,非抗Jo-1抗体阳性者10例),抗ARS抗体阴性者15例。抗ARS抗体阳性者更容易合并肺间质病变(P<0.05),肌无力、技工手表现更常见于抗Jo-1抗体阳性的患者(P<0.05),非抗Jo-1抗体阳性患者多表现为无肌病的DM病程(P<0.05)。结论非抗Jo-1抗体阳性的抗ARS抗体阳性患者与抗Jo-1抗体阳性患者的临床症状相似,非特异性间质性肺炎重叠机化性肺炎(NSIP/OP)在抗Jo-1抗体阳性的PM/DM患者中较为常见。当临床表现为无肌病的DM病程且抗Jo-1抗体阴性时,需警惕非Jo-1抗体综合征。
Objective To describe the clinical characteristics ofpolymyositis/dermatomyositis （PM/DM） with anti-aminoacyl-tRNA synthetase （ARS） antibody positive. Methods The clinical, laboratory and radiographic results of PM/DM patients hospitalized in our department from September 2014 to November 2017 were retrospectively analyzed. Results A total of 39 patients were diagnosed （14 cases positive for anti-Jo-1 antibody, 10 cases positive for non-anti-Jo-1 ARS antibodies, and 15 negative for ARS antibodies）. The frequency of ARS antibodies positive patients who had interstitial lung disease was higher than those patients without ARS antibodies （P〈0.05）. Amyosthenia and mechanic＇s hand were more common in the patients with anti-Jo-1 positive （P〈0.05） and the frequency of clinical amyopathic dermatomyositis in non-anti-Jo-1 positive patients was significantly higher （P〈0.05）. Conclusions The clinical characteristics are similar between anti-Jo-1-positive and non-Jo-1 ARS antibodies positive patients. Most PM/DM patients carrying anti-Jo-1 antibodies with interstitial lung disease own typical imaging characteristics of nonspecific interstitial pneumonia overlap organizing pneumonia （NSIP/OP）. It can be diagnosed of non-anti-Jo-1 antibody syndrome although there is no clinical manifestation of myositis and anti-jo-1 antibody is negative.
作者
王丽平
刘斌
李学任
彭守春
WANG Liping;LIU Bin;LI Xueren;PENG Shouchun(Department of Respiratory and Critical Care Medicine,Affiliated Hospital of Logistics University of Chinese People＇s Armed Police Force,Tianjin 300162,P.R.China)
出处
《中国呼吸与危重监护杂志》
CAS
CSCD
北大核心
2018年第6期570-576,共7页
Chinese Journal of Respiratory and Critical Care Medicine
基金
国家自然基金项目(81600051)
武警后勤学院基础研究项目(WHJ2016019)
