混合性结缔组织病肌炎的预测因素:多中心回顾性研究

IF 1.4 4区 医学 Q3 RHEUMATOLOGY
ARP Rheumatology Pub Date : 2024-07-01 DOI:10.63032/BAYU2491
Ana Teresa Melo, Manuel Silvério-António, Joana Martins-Martinho, Francisca Guimarães, Eduardo Dourado, Daniela Oliveira, Jorge Lopes, André Saraiva, Ana Gago, Margarida Correia, Ana Lúcia Fernandes, Sara Dinis, Rafaela Teixeira, Susana Pinto Silva, Carlos Costa, Tiago Beirão, Carolina Furtado, Pedro Abreu, Nikita Khmelinskii
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引用次数: 0

摘要

目的:我们旨在确定混合结缔组织病(MCTD)肌炎的临床和血清学预测因素:我们旨在确定混合性结缔组织病(MCTD)肌炎的临床和血清学预测因素:我们在全国范围内开展了一项多中心回顾性研究,研究对象包括至少符合以下一种诊断标准的成人混合性结缔组织病患者:夏普氏、粕川氏、阿拉尔孔-塞戈维亚氏或卡恩氏。单变量分析根据情况采用Chi-square、Fisher exact、Student's t或Mann-Whitney U检验。采用二元逻辑回归法进行多变量分析:结果:共纳入 98 例患者。43.9%的患者患有肌炎,其中60.5%的患者在发病时患有肌炎。30名肌肉受累患者(70%)出现近端肌无力。28%的肌炎患者出现胃肠道受累,29%的患者出现呼吸道受累。在同一亚组患者中,41.7%的患者肌电图显示肌病模式,47.1%的患者肌肉活检显示组织学肌炎特征。发热(OR=6.96,P=0.022)是肌炎的独立预测因素,与性别、诊断年龄、血统和呼吸系统受累无关。非洲血统(OR=8.39,P=0.019)、发病时白细胞减少(OR=6.24,P=0.021)和诊断时年龄较小(OR=1.07/年,P=0.035)被认为是发病时肌炎的独立预测因素,与性别和毛细血管镜检查中的硬皮病模式无关:结论:肌炎是MCTD的一种常见表现,即使在发病初期也是如此。非洲血统、发病时白细胞减少、确诊时年龄较小以及发热都应促使对肌炎进行全面评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Predictors of myositis in mixed connective tissue disease: A multicentre retrospective study.

Objectives: We aimed to identify clinical and serological predictors of myositis in mixed connective tissue disease (MCTD).

Methods: We performed a nationwide, retrospective, multicentre study including adult-onset MCTD patients fulfilling at least one of the following diagnostic criteria: Sharp's, Kasukawa, Alarcón-Segovia, or Kahn's. Univariate analysis was performed using Chi-square, Fisher exact, Student's t or Mann-Whitney U tests, as appropriate. Multivariate analysis was performed using binary logistic regression.

Results: Ninety-eight patients were included. Myositis was observed in 43.9% of patients, of whom 60.5% had myositis at disease onset. Proximal muscle weakness was described in 30 patients with muscle involvement (70%). Gastrointestinal involvement was identified in 28% and respiratory involvement in 29% of myositis patients. In the same subgroup of patients, 41.7% had a myopathic pattern on electromyography, and 47.1% had histological myositis features in the muscle biopsy. Fever (OR=6.96, p=0.022) was an independent predictor of myositis, regardless of sex, age at diagnosis, ancestry, and respiratory involvement. African ancestry (OR=8.39, p=0.019), leukopenia at the disease onset (OR 6.24, p=0.021), and younger age at diagnosis (OR=1.07/year, p=0.035) were identified as independent predictors of myositis at disease onset, regardless of sex and scleroderma pattern in capillaroscopy.

Conclusions: Myositis is a common manifestation of MCTD, even at the disease onset. African ancestry, leukopenia at the disease onset, younger age at diagnosis, and fever should prompt a thorough evaluation for myositis.

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