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目的探讨特发性炎性肌病(IIM)合并感染患者的临床和血清学特点,寻找对该疾病合并感染时有鉴别意义的指标。方法对2009年~2012年在华西医院风湿免疫科住院的84例IIM患者进行回顾性分析,比较合并感染患者45例(感染组)和未合并感染患者39例(未感染组)的发热、皮疹、关节炎、肌无力或肌痛、吞咽困难等临床表现,同时分析患者的C反应蛋白(CRP)、血沉(ESR)、血清蛋白[白蛋白(ALB)、球蛋白(GLO)]、白细胞(WBC)、中性粒细胞百分率(N%)的变化。结果感染组ALB浓度低于未感染组,差异有统计学意义(P=0.049);N%、CRP、ESR、WBC、GLO与其他临床指标,均受感染的影响较少,差异无统计学意义(P>0.05);感染组患者的糖皮质激素用量不高于未感染组(P>0.05)。结论 IIM合并感染时大部分患者的ALB水平明显降低(P<0.05),对鉴别IIM是否合并感染有重要的临床参考价值,CRP升高不能鉴别IIM患者是否合并感染。
Objective To investigate the clinical and serological features of patients with idiopathic inflammatory myopathy (IIM) complicated with infection, and to find out the differential markers of the disease with co-infection. Methods A retrospective analysis of 84 IIM patients hospitalized in the Department of Rheumatology and Immunology of West China Hospital from 2009 to 2012 was conducted to compare the incidence of fever, rash in 45 patients with infection (infection group) and 39 patients without infection (uninfected group) , Arthritis, muscle weakness or myalgia, difficulty swallowing and other clinical manifestations. Meanwhile, CRP, ESR, serum albumin (ALB) and globulin (GLO) WBC), neutrophil percentage (N%) changes. Results The ALB concentration in infected group was lower than that in non-infected group (P = 0.049). N%, CRP, ESR, WBC, GLO and other clinical indicators were less affected by infection with no significant difference (P> 0.05). The dosage of glucocorticoids in infected patients was not higher than that in non-infected patients (P> 0.05). Conclusions The ALB level of most patients with IIM co-infection was significantly lower (P <0.05), which has important clinical reference value for identifying the co-infection of IIM. Elevated CRP can not differentiate IIM patients from co-infection.