| Objective: 1.To analyze the clinical features of dermatomyositis（DM）and polymyositis（PM）;2.Identify the independent risk factors of interstitial lung disease（ILD）in DM/PM patients.Method: A retrospective analysis was performed on 307 patients（DM197 and PM110）diagnosed with DM/PM hospitalized in a comprehensive tertiary hospital in Lan zhou from January 2016 to August 2021.Using SPSS 25.0 statistical software,the clinical characteristics and differences of DM/PM patients were analyzed by descriptive analysis,chi-square test and non-parameter test,and the independent risk factors of ILD in DM/PM patients were analyzed by univariate and multivariate logistic regression analysis.Results:1.Demographic characteristicsIn this study,the male to female ratio of 197 DM patients was 1:2.08,and the age of onset ranged from 4 to 82 years,with an average age of onset（46.26±17.08）years old.The male to female ratio of 110 PM patients was 1:3.58,the age of onset was 2 ～79 years old,and the average age of onset was（42.67±16.36）years old.2.Clinical features（1）The most common initial symptoms of DM/PM patients were skin damage（57.86%）and fatigue（49.10%）,respectively.The most common skin damage in the course of DM was periorbital edema purple erythema（52.28%）.The most common muscle damage in DM/PM patients was myasthenia of limbs.（2）The incidence of dysphagia in DM patients was significantly higher than that in PM patients（P = 0.045）;The incidence of lower limb myasthenia in PM patients was significantly higher than that in DM patients（P = 0.001）.3.Laboratory and auxiliary examination（1）The levels of creatine kinase（CK）,creatine kinase isoenzyme（CK-MB）,lactate dehydrogenase（LDH）,alanine aminotransferase（ALT）,aspartate aminotransferase（AST）and α-hydroxybutyrate dehydrogenase（HBDL）in PM patients were significantly higher than those in DM patients（P < 0.001）.（2）The positive rate of anti-melanoma differentiation-associated protein 5（MDA5）antibody in DM patients was significantly higher than that in PM patients（P < 0.001）;and the positive rate of anti-histamyl t RNA synthase（Jo-1）antibody and anti-glycine t RNA synthase（EJ）antibody in PM patients were significantly higher than that in DM patients（P = 0.037;P = 0.022）.（3）The percentage of monocytes（MO%）in DM patients was significantly higher than that in PM patients（P < 0.001）;and the white blood cell count（WBC）,neutrophil count（NE）,lymphocyte count（LY）,red blood cell count（RBC）and platelet count（PLT）in PM patients were significantly higher than those in DM patients（P < 0.05）.（4）Arrhythmia was the most common abnormal electrocardiogram in DM/PM patients.Mitral regurgitation was the most common in DM（44.94%）and tricuspid regurgitation was the most common in PM（36.67%）.（5）Myogenic damage was the most common electromyography in DM/PM patients,and some of them may also had neurogenic damage.The probability of neurogenic damage in DM patients was significantly higher than that in PM patients（P= 0.01）.（6）In muscle MRI,the incidence of inflammatory edema in DM patients was significantly higher than that in PM patients（P = 0.032）.4.Risk factors of ILD（1）Among 197 patients with DM,84 patients developed ILD.Age at onset ≥45years（OR = 7.385;P = 0.002）and positive anti-MDA5 antibody（OR = 8.057;P =0.003）were independent risk factors for ILD in DM patients.（2）Among 110 PM patients,50 patients developed ILD.Age of onset ≥45 years,（OR = 4.928;P = 0.001）joint pain（OR = 3.147;P = 0.042）and positive anti-Jo-1antibody（OR = 5.403;P = 0.007）were independent risk factors for ILD in PM patients.Conclusions:1.DM/PM was more common in women,and especially among PM patients.The peak age of onset of DM and PM was 40 to 59 years old.2.DM patients were more likely to have dysphagia than PM patients,and PM patients were more likely to have myasthenia of lower limbs than DM patients.3.The levels of myase in PM patients were higher than those in DM patients.4.DM/PM patients were prone to ILD.Age at onset ≥45 years and positive antiMDA5 antibody were independent risk factors for ILD in DM patients.Age of onset≥45 years,joint pain and positive anti-Jo-1 antibody were independent risk factors for ILD in PM patients. |
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