皮肌炎皮损和受累肌肉中细胞凋亡的研究

目的 探讨皮肌炎皮损、肌细胞及浸润淋巴细胞凋亡的表达及皮质类固醇激素的影响。方法 对22个标本用TUNEL原位末端标记法检测角质形成细胞，肌细胞及淋巴细胞凋亡。10例用皮质激素者为A组，12例未用者为B组。结果 A组角质形成细胞、肌细胞及淋巴细胞有较多的凋亡，凋亡指数（AI）明显大于B组（P＜0．05）。皮质类固醇激素使用时间在2周以内者，凋亡细胞较少，在观察中未发现凋亡与皮肤、肌肉病理损害程度有关。结论 皮质类固醇激素可能具有诱导角质形成细胞、肌细胞及淋巴细胞凋亡的作用，这可能是皮质类固醇激素的治疗机理之一。激素使用时间的长短似与细胞凋亡程度有关。

Expression of apoptosis of the skin lesion and muscle from patients with dermatomyositis]

OBJECTIVE: This study inquired into the relationship between the influence of corticosteroid and the expression of apoptosis, Fas and Bcl-2 in muscle from patients with dermatomyositis (DM). METHODS: Corticosteroid was given to group A (10 DM cases) but not given to group B (12 DM cases). RESULTS: Apoptotic cells were detected in situ by terminal deoxynucleotidyl transferase-mediated-dUTP nick end labeling (TUNEL). Fas and Bcl-2 expressions was determined with the use of immunohistochemical staining in DM. The results showed that more expression of apoptosis in keratinocytes, muscle cells and lymphocytes were observed in group A. The apoptotic index (AI) of muscle cells and that of lymphocytes were more marked in group A than in group B (P < 0.05). Less apoptosis cells were observed in two weeks of treatment, and no correlation was found between apoptosis and the lesion of skin and muscle. CONCLUSION: The authors suggest that corticosteroid may play a role in inducing the apoptosis of keratinocytes, muscle cells and lymphocytes, which may be one of the therapeutic mechanisms of corticosteroid. The length of administering corticosteroid to the patients seems related to apoptosis.