小儿急性良性肌炎38例临床分析

目的：探讨小儿急性良性肌炎的病因、临床特点、鉴别诊断及转归。方法：分析2007年1月～2009年1月38例A,JL急性良性肌炎的临床资料。结果：38例中92．1％病前有上呼吸道感染，73．7％冬春季节发病，男孩多见。38例均有突然发作行走困难、跛行、肌痛，累及双侧小腿或大腿肌肉，急性期血清肌酸磷酸激酶（CK）显著升高。30例做病原学检查，5例柯萨奇病毒IgM阳性，4例分离出B流感病毒，3例支原体抗体阳性，2例EB病毒PCR阳性，16例未检出病原。经过治疗81．6％在7d内疼痛消失，CK恢复正常，2例疾病复发。结论：小儿急性良性肌炎起病突然，据其临床特征及急性期血清CK显著增高，诊断并不困难，需与格林－巴利综合征、流行性肌痛等鉴别。其病原除B流感病毒外，柯萨奇病毒、支原体及EB病毒也可能为本病病原。该病有复发可能，其机制有待进一步探讨。

Clinacal analysis of 38 cases with pedo-acute benign myositis

Obstractive：To investigate the etiology,cllmcal leatures,diagnosis and prognosis of peoo-acute oenlgn myositis. Methods ：Collect the cases of pedo-acute benign myositis in our department from January 2007 to September January 2009,and do clinical analysis. Results：92.1% in 38 cases of upper respiratory tract infection before disease, 73.7% onset in winter and spring,boys were more common. All of the 38 cases were sudden onset of difficulty in walking,limp,muscle pain,involving bilateral cnemis or thigh muscle,creatine phosphokinase （CK） in acute-phase serum was significantly higher. Etiology of 30 cases was tested ,of which 5 cases of coxsackie virus IgM positive, 4 cases being isolated influenza B virus, 3 cases of mycoplasma antibody positive, 2 cases of EB virus-PCR positive, 16 cases were not detected the pathogen. After treatment,the pain disappeared,CK returned to normal for 81.6% within 7 days. Two patients recurred. Conclusion ：Pedo-acute benign myositis ,with sudden onset and good process ,of which diagnosis is not difficult according to its clinical features and CK significantly higher in acute-phase serum. It should be identified with Guillain-Barre syndrome ,epidemic myalgia ,and so on. In addition to influenza B viruses ,the Coxsackie virus ,myeoplasma ,and EB virus may also become the pathogen of this disease. Pedo-acute benign myositis was found to be recrudescent,the mechanism was unknown.