单纯性多发性肌炎和皮肌炎的病程演变

目的　探讨单纯性多发性肌炎和皮肌炎的病程演变规律，以期获得对该病较全面的认识，指导临床治疗。方法　对６２ 例单纯性多发性肌炎和皮肌炎病程演变、临床病理和治疗相互间关系进行分析研究。结果　起病急、进展快、病情在半年内发展至高峰者，临床上以发热、肌痛、颈肌无力和吞咽困难常见，病理以急性炎症改变突出，及时治疗疗效好；而起病隐匿、进展缓慢、病情半年以上仍在进展者，以肢体肌无力多见，病理以间质改变更突出，预后较差，易迁延。结论　我们认为，病情在半年以内达高峰者可称为急性或亚急性单纯性多发性肌炎或皮肌炎，病情超过半年仍在进展者可称为慢性多发性肌炎或皮肌炎。

Clinical courses in 62 cases of polymyositis and dermatomyositis

Objective To investigate the clinical changes of the courses in 62 cases of polymyositis (PM) and dermatomyositis (DM). Methods 62 cases of PM and DM were analyzed in regard with the clinical courses and their relationship with the muscle pathological changes and therapy. Results There could be acute onset of fever, rapid development of myosalgia, neck weakness, and dysphagia with mainly acute inflammation in pathology presented if the course of the peak of the disease took place for less than 6 months. In these cases, the prognosis would be better, if prompt treatment would be given. In the other group of cases, the onset could be insidious with slow development persisting for more than half a year. Pathological study showed more limb muscle involvement and connective tissue proliferation if the course of the disease became longer than 6 months, therefor the prognosis would be poorer. Conclusions It would be worthwhile to call the disease acute or subacute type for PM/DM with the course of less than 6 months and it would be fit to take the disease as a chronic type for the course of longer than 6 months.