Evaluation of clinical prognostic factors for interstitial pneumonia in anti-MDA5 antibody-positive dermatomyositis patients
Evaluation of clinical prognostic factors for interstitial pneumonia in anti-MDA5 antibody-positive dermatomyositis patients
复制标题
DOI：
10.1080/14397595.2017.1318468
复制
发表时间：
2018-01-01
影响因子：
2.2
通讯作者：
Makino, Shigeki
中科院分区：
文献类型：
--
作者：
Fujiki, Youhei;Kotani, Takuya;Makino, Shigeki
目的：我们回顾性研究了抗黑色素瘤分化相关基因 5 (MDA5) 抗体 (Ab) 阳性皮肌炎 (DM) 患者间质性肺炎 (IP) 的临床预后因素。方法：受试者包括 18 名抗 MDA5 Ab 阳性 DM-IP 患者（9 名幸存者；9 名死亡）。结果：初始血清白蛋白水平、铁蛋白水平和毛玻璃样混浊 (GGO)死亡组右中叶的评分显着高于幸存者组（分别为 p = .033、.013 和 .005）。死亡组的初始肺泡动脉氧梯度 (P[A-a]O-2) 也高于幸存者组 (p = .064)。初始血清铁蛋白、P[A-a]O-2 和右中叶 GGO 评分被发现与死亡显着相关。初始铁蛋白水平 >= 450 ng/mL (25%)、P[A-a]O-2 >= 30 mmHg (31%) 和右中叶 GGO 评分 >= 2 (11%) 的患者 24 周后的生存率显着低于其他患者（分别为 p = .006、.020 和 .002）。 结论：初始血清铁蛋白水平>= 450 ng/mL、P[A-a]O-2>= 30 mmHg、右中叶GGO评分>= 2（GGO>= 肺叶的5%）被确定为抗MDA5 Ab阳性DM-IP患者的不良预后因素。
Objectives: We retrospectively investigated clinical prognostic factors for interstitial pneumonia (IP) in anti-melanoma differentiation-associated gene 5 (MDA5) antibody (Ab)-positive dermatomyositis (DM) patients.Methods: Subjects comprised 18 patients with anti-MDA5 Ab-positive DM-IP (9 survivors; 9 deaths).Results: Initial serum albumin levels, ferritin levels, and ground-glass opacity (GGO) scores in the right middle lobes were significantly higher in the death group than in the survivor group (p = .033, .013, and .005, respectively). Initial alveolar-arterial oxygen gradient (P[A-a]O-2) was also higher in the death group than in the survivor group (p = .064). Initial serum ferritin, P[A-a]O-2, and right middle lobe GGO score were found to significantly relate to death. Survival rates after 24 weeks were significantly lower among patients with an initial ferritin level of >= 450 ng/mL (25%), P[A-a]O-2 of >= 30 mmHg (31%), and a right middle lobe GGO score of >= 2 (11%) than each of the others (p = .006, .020, and .002, respectively).Conclusions: An initial serum ferritin level of >= 450 ng/mL, P[A-a]O-2 of >= 30 mmHg, and right middle lobe GGO score of >= 2 (GGO >= 5% of the lobe) were identified as poor prognostic factors for anti-MDA5 Ab-positive DM-IP patients.