429例系统性硬化症患者伴发肌病的临床分析

吴婵媛; 王迁; 徐东; 侯勇; 曾小峰

doi:10.16462/j.cnki.zhjbkz.2016.10.007

429例系统性硬化症患者伴发肌病的临床分析

doi: 10.16462/j.cnki.zhjbkz.2016.10.007

中国医学科学院北京协和医院风湿免疫科, 北京 100032

基金项目:

国家自然科学基金（81102268）

详细信息

作者简介:
吴婵媛(1980-),女,北京人,主治医师,博士。主要研究方向:风湿免疫学。

中图分类号: R181.26
计量
- 文章访问数: 312
- HTML全文浏览量: 57
- PDF下载量: 8
- 被引次数: 0
出版历程
- 收稿日期: 2016-06-10
- 修回日期: 2016-08-19

Prevalence and clinical significance of systemic sclerosis-associated myopathy in 429 patients

Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital(West Campus), Chinese Academy of Medical Sciences, Beijing 100032, China

摘要

摘要: 目的探讨系统性硬化症（systemic sclerosis，SSc）伴发肌病患者的临床特征。方法对2009年2月~2015年12月在北京协和医院欧洲抗风湿病联盟硬皮病试验研究组（European scleroderma trials and research group，EUSTAR）数据库中收集的SSc患者的肌肉合并症进行横断面分析，比较SSc伴发肌病组和无肌病组的流行病学及临床资料，分析两组间的差异。结果共有资料完整患者429人纳入本研究，平均发病年龄为（39.3±12.6）岁，SSc伴发肌病的发生率为22.6%。两组比较，肌病组的早饱/呕吐（χ²=16.29，P<0.001）、吞咽困难（χ²=27.01，P<0.001）、浮肿（χ²=17.74，P<0.001）及尿量减少（χ²=4.59，P=0.032）发生率高于无肌病组。SSc伴发肌病组超声心动图检查提示肺动脉压升高的发生率（χ²=6.31，P=0.012）高于无肌病组。SSc伴发肌病组的血沉（t=1.06，P=0.011）和C反应蛋白水平（t=0.87，P=0.001）高于无肌病组。结论 SSc伴发肌病不少见，与疾病的炎症程度及肾脏受累、心脏和肺并发症相关，临床需加强对SSc伴发肌病患者的关注并警惕与心脏和肾脏相关的并发症。
- 硬皮病,系统性 /
- 肌疾病 /
- 肌炎
Abstract: Objective To explore the prevalence of and clinical manifestation associated with myopathy in Chinese patients with systemic sclerosis(SSc). Methods This study was a cross-sectional study based on European Scleroderma Trials and Research group (EUSTAR) database in Peking Union Medical College Hospital(PUMCH) from February 2009 to December 2015. Demographic, clinical and laboratory data were analyzed in groups with and without myopathy. Results Of 429 Chinese SSc patients whose mean age of onset was (39.3±12.6) years old. Overall prevalence of myopathy was 22.6%. The presence of early satiety/vomiting(χ²=16.29, P<0.001), dysphagia (χ²=27.01,P<0.001), edema (χ²=17.74, P<0.001), and urine decreased(χ²=4.59, P=0.032) occurred more frequent in patients with myopathy than those without myopathy. The abnormal rate of pulmonary arterial hypertension (PAH) detected by echocardiography in the myopathy group was higher than that of non-myopathy group (χ²=6.31, P=0.012). The elevation of erythrocyte sedimentation rate (t=1.06, P=0.011) and C reactive protein (t=0.87, P=0.001) were more higher in myopathy group than in non-myopathy group. Conclusions SSc associated myopathy is not uncommon. Compared to non-myopathy patients, SSc patients associated myopathy have a more severe inflammation response, and require more attention on cardiac and renal complications.
- Sclerosis,systemic /
- Myopathy /
- Myositis

HTML全文

参考文献(14)

Ranque B, Authier FJ, Berezne A, et al. Systemic sclerosis-associated myopathy[J]. Ann N Y Acad Sci, 2007,1108:268-282.

Lóránd V, Czirják L, Minier T. Musculoskeletal involvement in systemic sclerosis[J]. Presse Med, 2014,43(10 Pt 2):e315-328.

Follansbee WP, Zerbe TR, Medsger TA Jr. Cardiac and skeletal muscle disease in systemic sclerosis (scleroderma): a high risk association[J]. Am Heart J, 1993, 125(1):194-203.

徐东,李梦涛,侯勇,等. 系统性硬化病患者临床表现分析:来自中国欧洲抗风湿病联盟硬皮病试验研究组数据库资料[J]. 中华风湿病学杂志, 2011,15(7):455-459.

Preliminary criteria for the classification of systemic sclerosis (scleroderma). Subcommittee for scleroderma criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee[J]. Arthritis Rheum, 1980,23(5):581-590.

Mimura Y, Ihn H, Jinnin M, et al. Clinical and laboratory features of scleroderma patients developing skeletal myopathy[J]. Clin rheumatol, 2005,24(2):99-102.

Steen V, Domsic RT, Lucas M, et al. A clinical and serologic comparison of African American and Caucasian patients with systemic sclerosis[J]. Arthritis Rheum, 2012,64(9):2986-2994.

Walker UA, Tyndall A, Czirjak L, et al. Clinical risk assessment of organ manifestations in systemic sclerosis: a report from the EULAR Scleroderma Trials And Research group database[J]. Anna Rheum Dis, 2007,66(6):754-763.

Steen VD. Autoantibodies in systemic sclerosis[J]. Semin Arthritis Rheum, 2005,35(1):35-42.

Ranque B, Berezne A, Le-Guern V, et al. Myopathies related to systemic sclerosis: a case-control study of associated clinical and immunological features[J]. Scand J Rheumatol, 2010,39(6):498-505.

左婷,蒋真,李向培,等. 系统性硬化症相关肺间质病变临床特征分析及随访观察[J]. 中华疾病控制杂志, 2015,19(9):918-921.

Roberts CG, Hummers LK, Ravich WJ, et al. A case-control study of the pathology of oesophageal disease in systemic sclerosis (scleroderma)[J]. Gut, 2006,55(12):1697-1703.

Ranque B, Authier FJ, Le-Guern V, et al. A descriptive and prognostic study of systemic sclerosis-associated myopathies[J]. Ann Rheum Dis, 2009,68(9):1474-1477.

Allanore Y, Meune C, Vonk MC, et al. Prevalence and factors associated with left ventricular dysfunction in the EULAR Scleroderma Trial and Research group (EUSTAR) database of patients with systemic sclerosis[J]. Ann Rheum Dis, 2010,69(1):218-221.

施引文献

资源附件(0)

访问统计