Clinical Analysis Of 105 Cases Of Dermatomyositis/Polymyositis/Caccer-associated Myositis And Related Research On Peripheral Blood Lymphocyte Subsets

Objective:To clarify the differences in the levels of peripheral blood lymphocyte subsets among patients with dermatomyositis(DM),polymyositis(PM),cancer-associated myositis(CAM)and healthy people.To compare the clinical characteristics,inflammatory indexes,the myocardial enzyme spectrum,lymphocyte subsets in peripheral blood of patients with dermatomyositis,polymyositis and cancer-associated myositis.Methods:A total of 105 patients admitted to our hospital from December 2017 to June 2019were collected,including 56 cases of dermatomyositis,24 cases of polymyositis,and 25cases of cancer-associated myositis.Include general information of patients(gender,age,course of disease),clinical characteristics(myalgia,muscle weakness,pulmonary interstitial disease,joint pain,Raynaud’s phenomenon),autoantibodies(anti-ANA antibody,anti-Jo-1 antibody,anti-Mi-2 antibodies,anti-SRP antibodies,anti-Ro-52 antibodies),ESR,C-reactive protein(CRP),alanine aminotransferase(ALT),aspartate aminotransferase(AST),creatine Related indicators such as kinase(CK),creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH),a-hydroxybutyrate dehydrogenase(HBDH),peripheral blood lymphocyte subsets and cytokines,At the same time,103 healthy people from our physical examination center were selected as controls for peripheral blood lymphocyte subsets.Results:1.Comparison of DM/PM/CAM patients with healthy control group,peripheral blood T cells,NK cells,CD4~+T cells,CD8~+T cells,Th1 cells,Th17 cells and Treg cells were significantly reduced in the three groups(P<0.05).2.Comparison between groups,the levels of NK cells,Treg cells and IFN-γin peripheral blood of patients with CAM were significantly lower than those in DM/PM patients(P=0.001,P<0.001,P=0.016),while those in DM/PM patients had peripheral blood NK cells,Treg cells and IFN-γlevels were not statistically different(P>0.05);and peripheral blood T cells,B cells,CD4~+T cells,CD8~+T cells,Th1 cells,Th2 cells,Th17 cells and IL-2,IL-4,IL-6,IL-10,TNF-αlevels in three groups of patients the difference was not statistically significant(P>0.05).3.The age of onset and the ESR level of CAM patients were higher than those of DM/PM(P<0.05,P<0.01),while the age of onset and erythrocyte sedimentation level of DM/PM patients were not statistically different(P>0.05);There was no significant difference in the course of disease and the levels of CRP,ALT,AST,CK,CK-MB,LDH,and HBDH(P>0.05).4.The incidence of Raynaud’s phenomenon,pulmonary interstitial lesions,and anti-Jo-1antibodies in CAM patients was lower than in DM/PM patients(P<0.05),while the incidence of pulmonary interstitial lesions in patients with DM was higher than in patients with PM(P=0.044),Raynaud’s phenomenon and the incidence of anti-Jo-1 antibodies were not significantly different from those in PM patients(P>0.05).There was no significant difference in myalgia,myasthenia,arthralgia,and anti-ANA antibody,anti-Mi-2antibody,anti-SRP antibody,and anti-Ro-52 antibody among the three groups of patients(P>0.05).Conclusion:Patients with dermatomyositis/polymyositis/cancer-associated myositis have an autoimmune imbalance and are characterised by a reduction in the number of peripheral blood lymphocyte subsets.Decreased levels of regulatory T cells and IFN-γmay be associated with the development of tumor-associated myositis.More old age and faster ESR are risk factors for tumor-associated myositis,while interstitial lung disease,Raynaud’s phenomenon,and positive anti-Jo-1 antibodies is associated with reduced risk.Patients with dermatomyositis are susceptible to pulmonary interstitial disease,and chest HRCT examination should be strengthened clinically.