多发性肌炎与甲状腺功能减退性肌病的鉴别诊断

目的为鉴别诊断多发性肌炎与甲状腺功能减退性肌病,对二者的异同点进行探讨。方法回顾分析12例多发性肌炎和10例甲状腺功能减退性肌病患者的临床表现、实验室检查资料。结果多发性肌炎与甲状腺功能减退性肌病在肌肉方面的临床表现相似,但急性炎症指标、自身抗体、肌肉病理检查结果多有不同,甲状腺功能检查结果明显不同。结论甲状腺功能检查有助于两病的鉴别,对于肌肉无力和肌酶升高的患者需常规检测甲状腺功能。     

Polymyositis presenting as sick sinus syndrome

A 39-year-old woman presented with palpitations, presyncope and muscular weakness. Electrocardiographic monitoring and electrophysiological studies confirmed the tachycardia-bradycardia form of the sick sinus syndrome and subsequent investigations including an endomyocardial biopsy demonstrated polymyositis as the cause.     

Autoimmunity in chronic lymphocytic leukaemia.

Seventy-nine patients with chronic lymphocytic leukaemia were evaluated for the presence of autoimmune diseases and autoantibodies. One patient has polymyositis and two additional patients presented with features suggestive of pernicious anaemia and chronic active hepatitis. The Coombs'' direct test was positive in 7% and immune thrombocytopenia was present in 8.1% of patients. Five (7%) patients had M-protein in the serum. No increased frequency of other autoantibodies was noted in our study group. We conclude that the propensity to develop antibodies is restricted only to the haematopoietic system and that there is no increased frequency of non-haematological autoimmune diseases in chronic lymphatic leukaemia.     

甲状腺功能减退性肌病误诊为多发性肌炎10例分析

目的探讨甲状腺功能减退性肌病与多发性肌炎容易误诊的原因.方法回顾分析10例甲状腺功能减退性肌病患者的临床表现及实验室检查资料,并复习有关文献.结果甲状腺功能减退性肌病与多发性肌炎在肌肉方面的表现相似,但甲状腺功能检查可以鉴别,左甲状腺素替代治疗有效.结论对于肌肉无力和肌酶升高者需常规检测甲状腺功能.     

多发性肌炎的中医辨治临床研究

目的观察中医药治疗多发性肌炎的有效性和安全性,探讨中医中药辨证施治治疗多发性肌炎的理论和机制。方法选取自2009年1月～2010年10月多发性肌炎患者共40例,其中20例采用中医药辨证施治多发性肌炎作为观察组,另20例患者采用西医疗法（激素和免疫抑制剂治疗）,1个疗程后观察患者的治疗情况。结果观察组患者的治愈率达65%,总有效率95%,明显高于对照组,其差异有统计学意义（P〈0.05）。所有患者临床症状均有不同程度的改善,其中观察组在肌肉无力、肌肉萎缩、关节损害等方面改善情况优于对照组,其差异有统计学意义（P〈0.05）。结论中医中药治疗多发性肌炎能显著提高临床治疗效果及治愈率,改善患者预后,值得在临床上应用和推广。     

多发性肌炎/皮肌炎33例临床分析

目的探讨33例多发性肌炎，皮肌炎患者的临床及病理特点，以及这些特点与疗效及预后的关系。方法回顾性分析总结33例多发性肌炎，皮肌炎患者的临床表现及实验室资料。结果多发性肌炎，皮肌炎以肌无力、肌痛、血清肌酶谱增高为主要临床表现，伴肌电图及病理学检查异常；经肾上腺皮质激素和免疫抑制剂等治疗后，总有效率90．9％。结论多发性肌炎，皮肌炎的预后与分型、治疗时机有关，早期强有力的治疗可望改善预后。     

多发性肌炎和皮肌炎的肾脏损害分析

目的探讨多发性肌炎与皮肌炎合并肾脏损害的临床特点。方法收集2003年1月—2008年12月确诊为多发性肌炎和皮肌炎患者的临床资料,回顾性分析肾脏损害的发生率、损害程度和临床预后。结果在确诊的146例多发性肌炎和皮肌炎患者中,107例(73.29%)首诊于皮肤科,仅4例(2.74%)首诊于肾脏科;共30例患者出现不同程度的肾脏损害,发生率为20.5%。肾脏损害表现为单纯血尿者10例(33.33%),单纯蛋白尿6例(20.00%),蛋白尿合并血尿13例(43.33%),高血压7例(23.33%),水肿3例。10例单纯血尿患者中,镜下血尿>+++者7例;11例接受24 h尿蛋白定量检测患者中,尿蛋白<1 g/d者7例;4例首诊于肾脏科的患者均接受肾穿刺活组织检查,发现局灶节段性肾小球硬化2例,肾小球轻微病变和狼疮性肾炎各1例。所有患者均给予免疫抑制剂治疗。痊愈1例,病情好转或无恶化23例,治疗有效率为80.00%;5例患者死亡(4例并发多脏器功能衰竭,1例合并肺癌),病死率16.67%。结论多发性肌炎和皮肌炎患者发生肾脏损害并非罕见,临床表现为较明显的镜下血尿、少量蛋白尿和轻、中度高血压以及轻度肾功能异常;患者对免...     

Fatal myocarditis with acute polymyositis in a young adult

A 21 year old woman presented with acute polymyositis associated with fatal myocarditis. The significance of cardiac involvement in polymyositis is discussed in relation to this unusually fulminant case.     

Polymyositis complicating D-penicillamine treatment.

Although there is good evidence that D-penicillamine can induce polymyositis, the exact pathogenic mechanism remains unclear. We report two patients with psoriatic arthritis and primary biliary cirrhosis respectively, who developed polymyositis while receiving D-penicillamine treatment for their primary diseases. Whether D-penicillamine treatment was the sole cause of polymyositis or acted as a trigger for the development of a secondary autoimmune disease is discussed.     

Leuco-erythroblastosis following withdrawal from glucocorticoid therapy.

Leuco-erythroblastosis has many known associations (Burkett, Cox and Fields, 1965; Weick, Hagedorn and Linman, 1974; Retief, 1964), but the only ones related to drug therapy are the well established response to haematinics (Burkett et al., 1965) and one possible case following anti-epileptic therapy (Retief, 1964). The case described below is of leuco-erythroblastosis following steroid withdrawal in a young man with primary polymyositis.     

多发性肌炎与皮肌炎(附25例报告)

多发性肌炎与皮肌炎25例,其中多发性肌炎21例,皮肌炎2例,多发性肌炎或皮肌炎伴发恶性肿瘤2例。从临床表现、生化检查、肌电图及肌肉活检等方面进行分析,提出多发性肌炎与皮肌炎的诊断条件。本组均采用皮质类固醇治疗,5例合并免疫抑制剂治疗,其中临床治愈4例,显著好转10例,好转5例,无效2例,死亡4例。     

小儿多发性肌炎(附10例报告)

本文报告10例小儿多发性肌炎,占同期诊治的多发性肌炎总数的26.3%,用肾上腺皮质激素系统治疗的9例(4例还并用了CTX和(或)6-MP)中3例痊愈,1例显效,4例部分改善。结合文献对小儿多发性肌炎的诊断与治疗进行了讨论,强调早期诊治的重要性。     

实验性多发性肌炎动物模型制作的研究

目的 研究实验性多发性肌炎动物模型的制作方法。方法 利用家兔骨骼肌匀浆加弗氏完全佐剂多次免疫豚鼠制成实验性多发性肌炎模型,观察其症状表现、肌肉病理及肌酶谱的变化。结果 模型组豚鼠于免疫注射第5周开始有活动减少、倦怠嗜卧、食欲及体重明显下降等表现;肌肉病理活检可见模型组肌横纹模糊、消失,肌纤维排列紊乱或变性坏死,肌间结缔组织增生;肌酶谱中肌酸磷酸激酶(CK)、乳酸脱氢酶(LDH)和谷草转氨酶(AST)与对照组比较,均明显升高(P<0.01)。结论 提示本研究造模方法可作为研究人类多发性肌炎的一个重要手段,可为阐明其发病机理及治疗提供科学的理论依据。     

IMMUNOGLOBULIN DEPOSITIONS IN PERIPHERAL NERVES IN POLYMYOSITIS

An immunocytochemical study was performed in 6 peripheral nerve specimens from 6 cases of polymyositis.The results revealed that depositions of IgG,IgM,IgA and C3 were found in the epineurium,perineurium and the walls of capillaries.These findings demonstrated that depositions of immonoglobulins and the complement-mediated immunoreaction may play an important role in pathogenesis of polymyositis with peripheral nerfve involvements.     

Polymyositis in association with polycythaemia vera

Inflammatory myopathies are reported to be associated with various malignancies. This association is more commonly observed in cases of dermatomyosis and less frequently in polymyositis. Malignancies commonly reported in association with inflammatory myopathies include non-Hodgkin's lymphoma and ovarian, lung and gastric carcinomas, as well as nasopharyngeal malignancies. Polycythaemia vera as a cause of polymyositis is unknown. We report a case of polycythaemia vera in a female patient who developed polymyositis three years later.     

Acute polymyositis in an adult associated with Mycoplasma pneumoniae infection

A previously healthy adult developed a hitherto unreported major complication of Mycoplasma pneumoniae infection, namely acute polymyositis.     

Circulating autoantibody against human myoglobin in polymyositis

A passive hemagglutination method for circulating autoantibody to purified human skeletal muscle myoglobin has been developed. This antibody was detected in the sera of 22 of 31 patients with polymyositis. The incidence and the antibody titers were significantly higher than in other myopathies such as myasthenia gravis (P less than .02), Duchenne-type muscular dystrophy (P less than .001), and other conditions (P less than .001). This new antibody test is useful in diagnosing polymyositis.     

甲氨蝶呤联合泼尼松对多发性肌炎患者肌电图、肌力及血清疾病指标的影响

目的：研究甲氨蝶呤联合泼尼松对多发性肌炎患者肌电图、肌力及血清疾病指标的影响程度。方法：选取2010年6月-2013年11月本院收治的70例多发性肌炎患者为研究对象,随机分为对照组（泼尼松组,35例）和观察组（甲氨蝶呤联合泼尼松组,35例）,比较两组患者治疗前和治疗后4、12周时的肌电图、肌力及血清疾病指标水平。结果：观察组治疗后4、12周时肌电图及肌力检测指标均优于对照组,血清疾病指标水平也低于对照组,差异均有统计学意义（P均〈0．05）。结论：甲氨蝶呤联合泼尼松对多发性肌炎患者肌电图、肌力及血清疾病指标的影响大于单用泼尼松,对于患者疾病各方面的改善作用更为明显。     

多发性（皮）肌炎肌电图、肌活检及周围神经病理观察

对２５例原发性多发性（皮）肌炎肌电图进行分析。结果表明，９４％出现失神经电位；２０例运动神经传导速度减慢。此外，对２０例进行了肌活检，１５例进行了足外侧皮神经活检。肌电图对早期诊断该病具有重要的价值。     

Polymyositis associated with AIDS retrovirus

Two homosexual men were initially seen with polymyositis as the only manifestation of the acquired immunodeficiency syndrome (AIDS) retrovirus infection. They developed AIDS-related complex a few weeks later and typical AIDS two to six months after onset of muscle weakness. By use of anti-human T-cell lymphotropic virus type III antiserum and monoclonal antibodies to lymphocyte subsets in an immunofluorescence technique, viral antigens were found in the OKT4-positive lymphoid cells surrounding muscle fibers and invading the endomysia septa. We concluded that an initial infection with the AIDS retrovirus can be associated with polymyositis, which may be the first clinical manifestation of an impending AIDS-related complex or AIDS.