Evaluation of Prognostic Factors in Anti-MDA5 Antibody-Positive Patients in Chongqing, China: A Retrospective Study.
Evaluation of Prognostic Factors in Anti-MDA5 Antibody-Positive Patients in Chongqing, China: A Retrospective Study.
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中国重庆市抗 MDA5 抗体阳性患者的预后因素评估：一项回顾性研究
DOI：
10.2147/ijgm.s327751
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发表时间：
2021
影响因子：
2.3
通讯作者：
Tang L
中科院分区：
文献类型：
--
作者：
Zhou J;Huang W;Ren F;Luo L;Huang D;Tang L
我们研究的目的是阐明抗黑色素瘤分化相关基因5（抗MDA5）阳性患者的潜在预后因素。
我们将抗MDA5阳性患者分为死亡组和存活组，分析了临床特征的差异。
共纳入56例患者。死亡组有10例（17.9%），存活组有46例（82.1%）。死亡组的中位年龄大于存活组，分别为59.50岁和39.25岁，p<0.05。死亡组最初的淋巴细胞计数和白蛋白较低，红细胞沉降率、铁蛋白和乳酸脱氢酶较高（分别p<0.05）。胸部计算机断层扫描显示磨玻璃影在死亡组更常见（p<0.05），且该组最初无蜂窝状阴影。死亡组自身免疫性间质性肺炎的诊断率高于存活组（70%对13%，p<0.05）。死亡组甲泼尼龙每日最大剂量的中位数（160mg/d）高于存活组（48mg/d）（p<0.05）。
高龄、淋巴细胞计数和白蛋白低以及炎症标志物水平升高可能预示抗MDA5阳性患者预后不良。超大剂量糖皮质激素对这些患者可能没有额外益处。
Objective The aim of our study was to elucidate the potential prognostic factors in anti-melanoma differentiation-associated gene 5 (anti-MDA5)-positive patients. Methods We divided anti-MDA5-positive patients into death and survival groups. The differences in clinical characteristics were analyzed. Results A total of 56 cases were included. The death group comprised 10 (17.9%) cases, and the survival group comprised 46 (82.1%) cases. Median age of the death group was greater than the survival group, 59.50 years vs 39.25 years, p<0.05. The death group had lower lymphocyte count and albumin and higher erythrocyte sedimentation rate, ferritin and lactate dehydrogenase initially (p<0.05, respectively). Ground-glass opacity on chest computed tomography was found more often in the death group (p<0.05), in which there was an absence of honey-combed shadow initially. The diagnosis of interstitial pneumonia with autoimmune features was higher in the death group than the survival group (70% vs 13%, p<0.05). The median dose of maximum daily methylprednisolone in the death group (160 mg/d) was higher than that in the survival group (48 mg/d) (p<0.05). Conclusion Advanced age, low lymphocyte count and albumin, and increased levels of inflammatory markers may portend poor prognosis in anti-MDA5-positive patients. Extra-large doses of glucocorticoid may have no additional benefit in these patients.