摘要
目的 分析抗Ro-52抗体对抗黑色素瘤分化相关基因5(MDA5)抗体阳性皮肌炎(DM)患者发生快速进展型间质性肺疾病(RP-ILD)及其预后的影响。方法 回顾性选取2019年10月至2021年12月于郑州大学第一附属医院确诊为抗MDA5抗体阳性的DM患者142例为研究对象。根据RP-ILD发生情况,将患者分为RP-ILD组(发生RP-ILD,53例)和非RP-ILD组(未发生RP-ILD,89例)。根据抗MDA5抗体滴度,将患者分为弱阳性组(抗MDA5抗体滴度为32~89 U/ml,22例)、中阳性组(抗MDA5抗体滴度为90~149 U/ml,32例)和强阳性组(抗MDA5抗体滴度≥150 U/ml,88例)。收集患者临床资料,采用多因素Logistic回归分析探讨抗MDA5抗体阳性DM患者发生RP-ILD的影响因素;采用Kaplan-Meier法绘制生存曲线,生存率的比较采用Log-rank检验。结果 RP-ILD组乳酸脱氢酶(LDH)、抗Ro-52抗体阳性率高于非RP-ILD组(P<0.05)。多因素Logistic回归分析结果显示,抗Ro-52抗体阳性是抗MDA5抗体阳性DM患者发生RP-ILD的危险因素〔OR=3.062,95%CI(1.396,6.715),P<0.05〕。弱阳性组、中阳性组、强阳性组抗Ro-52抗体阳性率比较,差异无统计学意义(P>0.05)。弱阳性组中,抗Ro-52抗体阳性患者RP-ILD发生率与抗Ro-52抗体阴性患者比较,差异无统计学意义(P>0.05);中阳性组、强阳性组中,抗Ro-52阳性患者RP-ILD发生率高于抗Ro-52抗体阴性患者(P<0.05)。弱阳性组、中阳性组、强阳性组生存率比较,差异有统计学意义(P<0.05)。抗MDA5抗体阳性DM患者、中阳性组中,抗Ro-52抗体阳性患者生存率低于抗Ro-52抗体阴性患者(P<0.05)。弱阳性组、强阳性组中,抗Ro-52抗体阳性患者与抗Ro-52抗体阴性患者生存率比较,差异无统计学意义(P>0.05)。结论 在抗MDA5抗体阳性DM患者中,抗Ro-52抗体阳性发生率较高,且其是患者发生RP-ILD的独立危险因素,与抗MDA5抗体阳性DM患者尤其是抗MDA5抗体滴度为90~149 U/ml的DM患者预后不良有关。
Objective To analyze the effects of anti-Ro-52 antibody on rapidly progressive interstitial lung disease(RP-ILD)and prognosis in patients with anti-melanoma differentiation associated gene 5(MDA5)antibody-positive dermatomyositis(DM).Methods A total of 142 DM patients diagnosed with anti-MDA5 antibody positive in the First Affiliated Hospital of Zhengzhou University from October 2019 to December 2021 were retrospectively selected as the research objects.According to the occurrence of RP-ILD,the patients were divided into RP-ILD group(with RP-ILD,n=53)and non-RP-ILD group(without RP-ILD,n=89).According to the anti-MDA5 antibody titers,the patients were divided into weak positive group(anti-MDA5 antibody titer was 32-89 U/ml,n=22),moderate positive group(anti-MDA5 antibody titer was 90-149 U/ml,n=32)and strong positive group(anti-MDA5 antibody titer was≥150 U/ml,n=88).The clinical data of the patients were collected,and multivariate Logistic regression analysis was conducted to analyze the risk factors for RP-ILD in anti-MDA5 antibody-positive DM patients.The Kaplan-Meier method was used to draw survival curves,and Log-rank test was carried out to compare the survival rates.Results Lactate dehydrogenase(LDH)and the positive rate of anti-Ro-52 antibody in RP-ILD group were higher than those in non-RP-ILD group(P<0.05).Multivariate Logistic regression analysis showed that anti-Ro-52 antibody was a risk factor for RP-ILD in anti-MDA5 antibody-positive DM patients[OR=3.062,95%CI(1.396,6.715),P<0.05].There was no significant difference in the positive rate of anti-Ro-52 antibody among weak positive group,moderate positive group and strong positive group(P>0.05).In the weak positive group,there was no significant difference in the incidence of RP-ILD between anti-Ro-52 antibody-positive patients and anti-Ro-52 antibody-negative patients(P>0.05).In the moderate positive group and the strong positive group,the incidence of RP-ILD in the anti-Ro-52 positive group was higher than that in the anti-Ro-52 antibody negative gr
作者
康悦
刘红
张国瑞
余亚丽
KANG Yue;LIU Hong;ZHANG Guorui;YU Yali(Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《实用心脑肺血管病杂志》
2022年第9期70-75,共6页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
国家重点研发计划精准医学研究专项(2016YFC0901100)。
关键词
皮肌炎
肺疾病
间质性
抗黑色素瘤分化相关基因5抗体
抗Ro-52抗体
Dermatomyositis
Lung diseases,interstitial
Anti-melanoma differentiation associated gene 5 antibody
Anti-Ro-52 antibody