皮肌炎114例临床分析

目的　探讨皮肌炎的临床特点。方法　对 114例皮肌炎患者进行临床分析。结果　该病可见于各个年龄组 ,女性略多于男性 ,80 %患者以下肢无力症状为首发。通过对 2 6例患者肌肉活检 ,阳性率达 10 0 %。对乳酸脱氢酶 ( L DH )、肌酸激酶 ( CK )、丙氨酸转氨酶 ( AL T)、天冬氨酸转氨酶 ( AST)等肌肉酶学的检查 ,其阳性率分别为 97%、93%、5 7%、5 4%。肌电图检查的阳性率为 95 .6 % ,主要表现为肌源性损害。15 %患者有肺部炎症表现 ,4%患者合并肿瘤 ,年龄均在 40岁以上。 15例死亡 ,死因分别为感染、肿瘤及心力衰竭。结论　首发症状不典型 ,对于不明原因的皮损患者 ,应注意有无四肢近端无痛性肌无力的表现 ,结合肌肉酶学、肌电图及肌肉活检等检查 ,早期诊断并不困难。对于 40岁以上的患者 ,应作全面的检查 ,以发现早期隐匿的恶性肿瘤

Clinical analysis of 114 cases of dermatomyositis

Objective To investigate the clinic characteristic of dermatomyositis (DM).Method One hundred and fourteen cases of DM were collected from the Qi Lu Hospital of Shandong University from 1994 to 1997.The criteria for the diagnosis of DM were based on the report of Bohan and Peter in 1975.Results The disease can be seen in all ages.Women are affected more frequently than men.Muscle weakness of low limb was observed in 80% cases at the onset.The abnormity of biopsy was seen in all cases.The muscle enzymes including lactic dehydrogenase (LDH),creatine kinase (CK),alanine aminotransferase (ALT) and aspartate aminotransferase (AST) all went up;positive rates were 97%,93%,57% and 54% respectively.There were 26 out of 26 DM patients (100%) with abnormal biopsy;66 out of 69 (95.6%) positive electromyography (EMG);5 out of 114 complicated with malignancy,15 died of pulmonary infection,tumor or heart failure.Conclusion The onset of DM isn′t typical.Early diagnosis should take muscle weakness,muscle enzymes,EMG and biopsy into account.Poor prognostic factors in DM were malignancy,pulmonary infection and heart failure.