ISSN 1004-4140
CN 11-3017/P
| Citation: |
ZHANG M X, LI L, GAO L, et al. Quantitative Indexes and Clinical Studies of Lung HRCT in Patients with Anti-MDA5 Antibody-positive Iims with Different Prognoses and Clinical Studies[J]. CT Theory and Applications, 2024, 33(3): 351-358. DOI: 10.15953/j.ctta.2023.217. (in Chinese).
|
Objective: To compare the quantitative parameters of lung HRCT and clinical manifestations of anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive idiopathic inflammatory myopathy (IIM) patients with different prognoses. Methods: The clinical and imaging data of 19 MDA5 antibody-positive IIM patients admitted to Beijing Shijitan Hospital Affiliated with Capital Medical University between February 2017 and November 2022 were retrospectively analyzed. According to the prognoses, the patients were divided into the good prognoses group (14 cases) and the poor prognoses (intubation or death) group (5 cases). The clinical and laboratory indexes, types of interstitial lung disease (ILD), and CT quantitative indexes were compared between the two groups. Results: There were significant differences in gender; carcinoembryonic antigen; blood oxygen saturation; and the percentages of lymphocytes, monocytes, neutrophils, lymphocytes, and neutrophils between the good versus the poor prognoses groups. The proportion of abnormal respiratory system changes was higher in the poor prognoses group. In terms of the type of ILD, acute interstitial pneumonia (AIP)-like lesions were the main type in the poor prognoses group, and nonspecific interstitial pneumonia (AIP) lesions were the main type in the good prognoses group. For NSIP-like lesions, there was a statistically significant difference between the two groups. The semi-quantitative score of the poor prognoses group was higher, and the volume of whole lung lesions as well as the proportion of whole lung lesions were also higher. Spearman correlation analysis showed that the blood oxygen saturation, monocyte percentage, semi-quantitative score, whole lung lesion volume, and proportion of whole lung lesion were negatively correlated, while carcinoembryonic antigen, neutrophil percentage, and neutrophils were positively correlated with the semi-quantitative score, whole lung lesion volume, and proportion of whole lung lesion. Conclusions: The lung HRCT quantitative indicators, clinical manifestations, and laboratory indicators are different in MDA5 antibody-positive IIM patients with different prognoses. Early evaluation of HRCT imaging manifestations, clinical manifestations, and laboratory indicators is of great significance in determining the prognosis of MDA5 antibody-positive IIM patients, which provides corresponding support for clinical diagnosis and treatment.
| [1] |
孙磊, 唐雪梅. 特发性炎性肌病分类及诊断标准的变迁[J]. 国际免疫学杂志, 2021, 44(5): 580−584. DOI: 10.3760/cma.j.issn.1673-4394.2021.05.017.
SUN L, TANG X M. Changes in classification and diagnostic criteria of idiopathic inflammatory myopathies[J]. International Journal of Immunology, 2021, 44(5): 580−584. DOI: 10.3760/cma.j.issn.1673-4394.2021.05.017. (in Chinese).
|
| [2] |
王虹丽, 吕基扬, 蔡月明, 等. 特发性炎症性肌病生物标志物的研究进展[J]. 国际免疫学杂志, 2023, 46(1): 87−92. DOI: 10.3760/cma.j.issn.1673-4394.2023.01.015.
WANG H L, LV J Y, CAI Y M, et al. Advances in biomarkers of idiopathic inflammatory myopathy[J]. International Journal of Immunology, 2023, 46(1): 87−92. DOI: 10.3760/cma.j.issn.1673-4394.2023.01.015. (in Chinese).
|
| [3] |
FIORENTINO D, CHUNG L, ZWERNER J, et al. The mucocutaneous and systemic phenotype of dermatomyositis patients with antibodies to MDA5 (CADM-140): A retrospective study[J]. Journal of the American Academy of Dermatology, 65(1): 25-34.
|
| [4] |
KIM M, HARVEY S, DANOFF S K, et al. Rapidly progressive interstitial lung disease in patients with anti-melanoma differentiation-associated gene 5-positive dermatomyositis: Serial changes on HRCT[J]. Emergency Radiology, 2022, 29(6): 961−967. DOI: 10.1007/s10140-022-02080-y.
|
| [5] |
李玲, 张明霞, 孙莹, 等. 基于深度学习的CT定量指标对糖尿病合并新型冠状病毒肺部感染的影像学研究[J]. CT理论与应用研究, 2023, 32(3): 373−379. DOI: 10.15953/j.ctta.2023.020.
LI L, ZHANG M X, SUN Y, et al. Imaging study of COVID-19 patients with diabetes mellitus by computed tomograpgh quantitative indicators based on deep learning[J]. CT Theory and Applications, 2023, 32(3): 373−379. DOI: 10.15953/j.ctta.2023.020. (in Chinese).
|
| [6] |
LUNDBERG I E, TJARNLUND A, BOTTAI M, et al. 2017 European League Against Rheumatism/American College of Rheumatology Classification Criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups[J]. Annals of the Rheumatic Diseases, 2017, 69(12): 2271−2282.
|
| [7] |
TRAVIS W D, COSTABEL U, HANSELL D M, et al. An official American Thoracic Society/European Respiratory Society statement: Update of the international multidisciplinary classification of the idiopathic interstitial pneumonias[J]. American Journal of Respiratory and Critical Care Medicine, 2013, 188(6): 733−748. DOI: 10.1164/rccm.201308-1483ST.
|
| [8] |
FINDLAY A R, GOYAL N A, MOZAFFAR T. An overview of polymyositis and dermatomyositis[J]. Muscle & Nerve, 2015, 51(5): 638−656.
|
| [9] |
KURTZMAN D, VLEUGELS R A. Anti-melanoma differentiation-associated gene 5 (MDA5) dermatomyositis: A concise review with an emphasis on distinctive clinical features[J]. Journal of the American Academy of Dermatology, 2018, 78(4): 776−785. DOI: 10.1016/j.jaad.2017.12.010.
|
| [10] |
高兰, 张国华, 张令令, 等. 35例皮肌炎/多发性肌炎患者临床特征分析[J]. 标记免疫分析与临床, 2021, 28(10): 1727−1731.
GAO L, ZHANG G H, ZHANG L L, et al. Clinical characteristics of 35 patients with dermatomyositis/dolymyositis[J]. Labeled Immunoassays and Clinical Medicine, 2021, 28(10): 1727−1731. (in Chinese).
|
| [11] |
GAN Y Z, ZHANG L H, MA L, et al. Risk factors of interstitial lung diseases in clinically amyopathic dermatomyositis[J]. Chinese Medical Journal, 2020, 133(6): 644−649.
|
| [12] |
LABRADOR-HORRILLO M, MARTINEZ M A, SELVA-O'CALLAGHAN A, et al. Anti-MDA5 antibodies in a large mediterranean population of adults with dermatomyositis[J]. Journal of Immunology Research, 2014, 2014: 290797.
|
| [13] |
DOUGLAS W W, TAZELAAR H D, HARTMAN T E, et al. Polymyositis-dermatomyositis-associated interstitial lung disease[J]. American Journal of Respiratory and Critical Care Medicine, 2001, 164(7): 1182−1185. DOI: 10.1164/ajrccm.164.7.2103110.
|
| [14] |
VOJINOVIC T, CAVAZZANA I, CERUTI P, et al. Predictive features and clinical presentation of interstitial lung disease in inflammatory myositis[J]. Clinical Reviews in Allergy & Immunology, 2021, 60(1): 87−94.
|
| [15] |
CHEN X, JIANG W, JIN Q, et al. Clinical, radiological and pathological features of anti-MDA5 antibody-associated interstitial lung disease[J]. RMD Open, 2023, 9(2).
|
| [16] |
CHEN F, ZUO Y, LI S, et al. Clinical characteristics of dermatomyositis patients with isolated anti-Ro-52 antibody associated rapid progressive interstitial lung disease: Data from the largest single Chinese center[J]. Respiratory Medicine, 2019, 155: 127−132. DOI: 10.1016/j.rmed.2019.07.020.
|
| [17] |
YOO H, HINO T, HWANG J, et al. Connective tissue disease-related interstitial lung disease (CTD-ILD) and interstitial lung abnormality (ILA): Evolving concept of CT findings, pathologyand management[J]. European Journal of Radiology Open, 2022, 9: 100419. DOI: 10.1016/j.ejro.2022.100419.
|
| [18] |
ZOU J, GUO Q, CHI J, et al. HRCT score and serum ferritin level are factors associated to the 1-year mortality of acute interstitial lung disease in clinically amyopathic dermatomyositis patients[J]. Clinical Rheumatology, 2015, 34(4): 707−714. DOI: 10.1007/s10067-015-2866-5.
|
Supported by: Beijing Renhe Information Technology Co. Ltd 
DownLoad: