环境因素对幼年皮肌炎(JDM)及其病程和难治性的影响。

IF 2 4区 医学 Q3 RHEUMATOLOGY
Clarissa C M Valões, Tamima M Arabi, Alfésio L F Braga, Lúcia M A Campos, Nádia E Aikawa, Kátia T Kozu, Clovis A Silva, Sylvia C L Farhat, Adriana M Elias
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引用次数: 0

摘要

摘要评估环境因素和早产对幼年皮肌炎(JDM)及其病程和治疗耐受性的影响:病例对照研究:35 名患者在一家三级医院接受随访,124 名健康对照者均为圣保罗居民。患者按单环、多环或慢性病程和难治性分类。污染物(可吸入颗粒物-PM10、二氧化硫-SO2、二氧化氮-NO2、臭氧-O3和一氧化碳-CO)的日浓度由圣保罗环境公司提供。通过问卷调查获得了人群数据:结果:15 名患者为单循环病程,19 名患者为多循环/慢性病程。18名患者对治疗无效。在多变量逻辑回归模型中,母亲职业性接触可吸入制剂(OR = 17.88;IC 95% 2.15-148.16,p = 0.01)和出生后第五年接触臭氧(第三三元组 > 86.28µg/m3;OR = 6.53,IC 95% 1.60-26.77,p = 0.01)是 JDM 的风险因素。在同一分析中,距离托儿所/学校 200 米以外有工厂/采石场(OR = 0.22;IC 95% 0.06-0.77;P = 0.02)是一个保护因素。早产、妊娠期接触空气污染物/香烟烟雾/母亲居住地和工作场所的可吸入污染物来源与JDM无关。早产、母亲在怀孕期间接触职业污染物以及患者在出生后第五年之前接触地面污染物与病程和治疗难治性无关:结论:JDM的风险因素是母亲的职业暴露和出生后第五年的臭氧暴露。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The influence of environmental factors related to Juvenile Dermatomyositis (JDM), its course and refractoriness to treatment.

Objective: To evaluate the influence of environmental factors and prematurity relating to juvenile dermatomyositis (JDM), its course and refractoriness to treatment.

Methods: A case-control study with 35 patients followed up at a tertiary hospital and 124 healthy controls, all residents of São Paulo. Patients were classified according to monocyclic, polycyclic or chronic disease courses and refractoriness to treatment. The daily concentrations of pollutants (inhalable particulate matter-PM10, sulfur dioxide-SO2, nitrogen dioxide-NO2, ozone-O3 and carbon monoxide-CO) were provided by the Environmental Company of São Paulo. Data from the population were obtained through a questionnaire.

Results: Fifteen patients had monocyclic courses, and 19 polycyclic/chronic courses. Eighteen patients were refractory to treatment. Maternal occupational exposure to inhalable agents (OR = 17.88; IC 95% 2.15-148.16, p = 0.01) and exposure to O3 in the fifth year of life (third tertile > 86.28µg/m3; OR = 6.53, IC95% 1.60-26.77, p = 0.01) were risk factors for JDM in the multivariate logistic regression model. The presence of a factory/quarry at a distance farther than 200 meters from daycare/school (OR = 0.22; IC 95% 0.06-0.77; p = 0.02) was a protective factor in the same analysis. Prematurity, exposure to air pollutants/cigarette smoke/sources of inhalable pollutants in the mother's places of residence and work during the gestational period were not associated with JDM. Prematurity, maternal exposure to occupational pollutants during pregnancy as well as patient's exposure to ground-level pollutants up to the fifth year of life were not associated with disease course and treatment refractoriness.

Conclusion: Risk factors for JDM were maternal occupational exposure and exposure to O3 in the fifth year of life.

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来源期刊
Advances in Rheumatology
Advances in Rheumatology Medicine-Rheumatology
CiteScore
4.00
自引率
4.30%
发文量
41
审稿时长
53 weeks
期刊介绍: Formerly named Revista Brasileira de Reumatologia, the journal is celebrating its 60th year of publication. Advances in Rheumatology is an international, open access journal publishing pre-clinical, translational and clinical studies on all aspects of paediatric and adult rheumatic diseases, including degenerative, inflammatory and autoimmune conditions. The journal is the official publication of the Brazilian Society of Rheumatology and welcomes original research (including systematic reviews and meta-analyses), literature reviews, guidelines and letters arising from published material.
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