多发性肌炎和皮肌炎的肺部病变

目的探讨皮肌炎(DM)和多发性肌炎(PM)患者的肺部病变的表现和特点。方法对1994-2003年在我院就诊的DM和PM患者进行临床、放射学、彩色多普勒心动超声、肺功能的检查,分析其结果。结果PM和DM患者累及肺部时呼吸道的临床表现较为隐匿,PM和DM肺部病变的发生率为41.4%(96和232例),其中肺间质改变最多见,其次为胸膜炎、肺部浸润性病变、肺大泡等;肺间质病变在影像学上最常见的表现为不规则网状、线状阴影,44.7%有两种以上混合性病变同时存在,以中下肺及肺外周多见,多对称分布(83.0%);肺动脉高压发生率为13.5%,多为轻度增高;92.9%肺功能异常(52和56例),其中小气道损害31例(59.6%)。结论DM和PM患者肺部病变的的发生率很高,在影像学上肺间质病变最常见,小气道是DM和PM常见的靶器官,表现隐匿,应引起重视。

Pulmonary manifestation in the paitients with Dermatomyositis和Poly-myositis

Objective To explore the manifestation and characteristics of pulmonary involvement in the paitients with Dermatomyositis(DM)/ Poly-myositis(PM).Methods 96 cases of DM/PM from 1994 to 2003 were subjected examinations with clinical,roentgenologic,Doppler echocardiography and lung functional observation.Results The total prevalence of respiratory involment was 41.4%,The change was the lung infiltration firstly,secondary was pleurisy,pulmonary hypertension,lung damage,pulmonary big-bubble etc;The common manifestation of the lung infiltration was irregular net and line umbra,44.7?ses have the compound damage existed,the middlelow part and lung peripheral are most seen,they were symmetrical distributed(83.0%).Conclusion The generation rate of the lung damage is very high.Lung,especially little airway is target organ.Its manifestation diversify,should be appreciated.