【摘要】 目的 分析成人抗黑色素瘤分化相关基因5(MDA5)抗体阳性皮肌炎(DM)的临床特征，并与抗MDA5抗体阴性DM进行比较。方法 收集2021年1月1日至12月31日郑州大学第一附属医院101例成人DM患者资料，根据抗MDA5抗体阳性与否分为抗MDA5抗体阳性(MDA5~+)组和抗MDA5抗体阴性(MDA5~-)组，对两组数据进行比较。收集抗MDA5抗体水平定量检测结果，分析其与其他实验室指标的相关性。结果 MDA5~+组较MDA5~-组初诊住院时间长，1 a内住院次数多，发热和咳嗽咳痰症状出现频率较高，差异具有统计学意义(P<0.05)。与MDA5~-组相比，MDA5~+组红细胞沉降率、涎液化糖链抗原-6(KL-6)、铁蛋白水平升高，中性粒细胞、淋巴细胞、血小板、肌酸激酶、肌酸激酶同工酶水平降低，差异有统计学意义(P<0.05)。Spearman相关分析显示，抗MDA5抗体水平与D-二聚体、免疫球蛋白G、免疫球蛋白M水平呈正相关，与肌酸激酶同工酶水平呈负相关(P<0.05)。高分辨率CT显示，MDA5~+组肺间质性改变较MDA5~-组发生率高，差异有统计学意义(P<0.05)。结论 MDA5~+DM较MDA5~-DM患者发热、咳嗽咳痰发生率高，肌肉受累较轻，易发生肺间质改变，病情较重，治疗较复杂。KL-6、铁蛋白、抗MDA5抗体水平可作为评估MDA5~+ DM病情活动的指标。更多还原

【Abstract】 Objective To analyze the clinical characteristics of anti-melanoma differentiation-associated gene 5(MDA5) antibody positive dermatomyositis(DM) in adults and compare them with anti-MDA5 antibody negative DM.Methods The data of 101 adult DM patients in the First Affiliated Hospital of Zhengzhou University from January 1 to December 31, 2021 were collected and divided into anti-MDA5 antibody positive(MDA5~+) group and anti-MDA5 antibody negative(MDA5~-) group according to the anti-MDA5 antibody positive or not. The data of the two groups were compared. The quantitative detection results of anti-MDA5 antibody were collected, its correlation with other laboratory indexes was analyzed.Results Compared with the MDA5~- group, the MDA5~+ group had longer hospital stay at initial diagnosis, more hospitalization times within one year, and higher frequency of fever, cough and sputum, the difference was statistically significant(P<0.05). Compared with the MDA5~- group, the levels of erythrocyte sedimentation rate, krebs von den lungen-6(KL-6) and ferritin were increased, and the levels of neutrophil, lymphocyte, platelet, creatine kinase and creatine kinase-MB were decreased in the MDA5~+ group, with statistically significant differences(P<0.05). Spearman correlation analysis showed a positive correlation between anti-MDA5 antibody levels and D-dimer, immunoglobulin G, immunoglobulin M and a negative correlation with creatine kinase-MB(P<0.05). The high resolution CT displayed a higher number of interstitial lung changes in the MDA5~+ group compared to the MDA5~- group, with a statistically significant difference(P<0.05).Conclusion Patients with MDA5~+ DM have a higher incidence of fever, cough and sputum than patients with MDA5~-DM, have less muscle involvement, are more prone to interstitial lung changes, and are more severely ill and complicated to treat. KL-6, ferritin, and anti-MDA5 antibody levels can be used as indicators to assess disease activity in MDA5~+ DM.更多还原