多发性肌炎/皮肌炎134例临床分析

目的:探讨多发性肌炎(PM)和皮肌炎(DM)患者的临床特点,以利临床诊断、指导治疗及判断预后.方法:回顾性分析本院134例PM和DM患者的临床首发症状及病程中临床表现、肌酶水平、肌电图、肌活检、治疗以及转归,并对PM和DM进行分析比较.结果:PM首发症状以发热肌痛、近端肌无力多见,DM则不论其病程长短均多数以皮肤损害为首发症状.PM患者出现肌酶升高明显高于DM组患者,CK在PM组和DM组中治疗前后的改变具统计学意义(P＜0.05).PM的病理改变主要表现为散在肌纤维萎缩;DM以束周萎缩多见.影响预后的主要因素年龄、肺部感染有关.结论:多发性肌炎和皮肌炎的临床特征及病理各有不同.

Clinical Analysis of 134 patients with Polymyositis/Dermatomyositis

Objective:To explore the clinical features of patients with polymyositis(PM) and dermatomyositis(DM) to provide evidence for clinical diagnosis,treatment and prognostic evaluation.Methods: Data of 134 cases of PM/DM concerning the initial symptoms,subsequent manifestations,muscle enzymes,electromyogram,muscle biopsy,treatment and prognosis were analyzed retrospectively and compared. Results: Patients with PM were more likely to have fever,myalgia and muscle weakness at the onset,while skin lesions were the initial signs in most of DM patients irrespective of duration of the disease.The elevation of muscle enzymes was more common in PM compared with DM,and the changes in CK among PM/DM patients were of statistical significance before and after treatment(P<0.05).The pathological study showed diffuse muscle fiber atrophy predominating in PM and perimysium atrophy in DM.Age and pulmonary infection were important factors related to prognosis.Conclusion: Differences in the clinical features and pathology between PM and DM was noted by this study.