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红细胞分布宽度的动态变化作为皮肤肌炎相关的快速进展性间歇性肺病中短期死亡率的预测因素

Fang Chen¹, Qiwen Jin¹, Yingfang Zhang¹

¹Department of Rheumatology, Key Laboratory of Myositis; Beijing Key Laboratory for Immune Mediated Inflammatory Diseases, China-Japan Friendship Hospital, Beijing, China.

|April 5, 2024

概括

红细胞分布宽度 (RDW) 可以识别患有异常性炎症性肌肉病 (IIM) 的患者,他们面临间歇性肺病 (ILD) 和不良结果的高风险. 升高的RDW及其随时间的变化预测了IIM患者快速进展的ILD (RP-ILD) 和死亡率.

科学领域:

肺部医学肺部医学
类风湿病学类风湿病学
临床生物标志物临床生物标志物

背景情况:

异形性炎症性肌肉病 (IIM) 与间歇性肺病 (ILD) 相关,这是死亡的主要原因.
确定IIM-ILD患有快速进展ILD (RP-ILD) 和不良结果的患者的风险对于及时干预至关重要.

研究的目的:

调查红细胞分布宽度 (RDW) 作为预测RP-ILD和IIM患者的短期死亡率的实用和可访问的标志物.
评估RDW水平与IIM患者ILD患病率和严重程度之间的关联.

主要方法:

从2009年至2021年对1822名IIM患者的回顾性评估.
包括532名先天性ILD患者和完整的医疗记录.
在初始诊断,3个月和最后的随访时收集和分析RDW值,以及临床数据和结果.

主要成果:

在IIM患者中观察到较高的ILD患病率,患者的RDW升高.
患有ILD和高RDW的患者表现出较低的肺功能 (PaO2 / FiO2,FVC%,DLco%) 和较高的RP-ILD率.
在IIM-ILD (HR=2.9,p=0.03) 中,RDW是预后的独立风险因素.
3个月内RDW的变化 (∆RDW-3) >0与皮肤肌炎-ILD (DM-ILD) 患者的3个月死亡率增加有关,特别是那些抗MDA5抗体阳性患者.

结论:

重复的RDW测量可以帮助临床医生识别具有RP-ILD高危IIM-ILD患者.
RDW作为一个有价值的预后标记,用于预测IIM-ILD的死亡率.
这种可访问的生物标志物可以指导IIM-ILD患者的风险分层和管理策略.

关键词:

抗体是一种抗体.皮肤肌肉菌性炎 (dermatomyositis) 是一种疾病.结果和过程评估,医疗保健聚合神经炎是一种多元神经炎.

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