甄莉 俞宝田 张成训 林玲 甄莉 俞宝田(100730 北京，中国医学科学院 中国协和医科大学北京协和医院皮肤科)；甄莉(现在山西医科大学第一临床医学院皮肤科)；张成训 林玲(中国医学科学院 中国协和医科大学统计教研室) 中华皮肤科杂志 1999 0 32 1


    关键词：皮肌炎；预后 期刊 zhpfkzz 0 论著 fur -->


    

【摘要 】 目的 探索皮肌炎患者致死的危险因素。方法 收集北京协和医院1970～1997年门诊和住院长期随诊的216例患者，符合Bohan和Peter1975年的诊断标准。随诊2～27年，平均(5.8±4.7)年。以临床资料和实验室各指标为参数，借助计算机SAS和Stata软件，用χ2检验和Logistic回归法对预后因素进行分析。结果 216例患者中43例死亡(19.9%)。24例(11.1%)伴发恶性肿瘤，死亡18例。合并肺纤维化32例(14.8%)，死亡13例。发病第1年病死率最高占患者9.7%，第2年和第5年的生存率分别为87.5%、81.5%。致死的危险因素为肺纤维化、恶性肿瘤和急性发病。老人和心脏疾患为非致死的危险因素。结论 肺纤维化、恶性肿瘤和急性发病为皮肌炎致死的危险因素。

Prognostic Factors in Dermatomyositis: AnAnalysis of 216 Cases

ZHEN Li,YU Baotian, ZHANG Chengxun, et al. Departmentof Dermatology, Peking Union Medical College Hospital, Chinese Academy of MedicalSciences, Beijing 100730

【Abstract 】 Objective Toinvestigate the life-threatening factors of dermatomyositis(DM). Methods 216 cases of DM were collected from the Peking Union Medical College Hospital in 1970 to1997 . The criteria for the diagnosis of DM were based on the report of Bohan and Peter in1975. The mean follow-up period of these patients was 5.8±4.7 years (ranged from 2 to 27years). The clinical and laboratory data were retrospectively analysed with the SAS andStata statistical software package, chisquare test was used for monofactorial study, andmultiple factors were analysed using logistic regression. Results Therewere 43 out of 216 DM patients (19.9%) died; among them, 18 out of 24 (11.1%)complicated with malignancy, 13 out of 32(14.8%)complicated with pulmonaryfibrosis.During the first year after onset, the mortality rate was quite high (9.7%).The survival rates were 87.5% in the second year and 81.5% in the fifth yearrespectively. Life-threatening factors were malignancy,pulmonary fibrosis and acute onsetof the disease. Aging and cardiac disorders were not identified as a fatal risk factor inthis series of patients. Conclusion Poor prognostic factors in DM weremalignancy, pulmonary fibrosis and acute onset of the disease.

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