| 程佑,杨艳,王明华.40例多发性肌炎/皮肌炎病人的临床特点分析[J].安徽医药,2019,23(2):283-286. |
| 40例多发性肌炎/皮肌炎病人的临床特点分析 |
| Analysis of the clinical features of 40 patients with polymyositis/dermatomyositis |
| 投稿时间：2017-03-05 |
| DOI： |
| 中文关键词: 多肌炎/皮肌炎 间质性肺病 血清肌酶 抗Jo-1抗体 |
| 英文关键词: Polymyositis/dermatomyositis Interstitial lung disease Serum creatine kinase Anti-Jo-1 antibody |
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| 摘要点击次数: 1945 |
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| 中文摘要: |
| 目的 提高临床医生对多发性肌炎(PM)/皮肌炎(DM)的正确诊断率。方法 对2012年12月至2017年1月期间贵州医科大学附属医院40例PM/DM病人的临床资料进行回顾性分析。结果 40例病人中女性26例,男性14例。临床表现以Heliotrope疹、皮肤瘙痒及乏力多见；实验室检查以血清肌酸激酶升高尤为常见。40例中33例病人行肌电图检查,其中28例(84.85%)出现不同部位的肌源性损害。40例中18例病人行肌肉活检,其中15例(84.00%)显示皮肤/肌肉炎性改变符合“PM/DM”表现。40例病人中12例出现心电图异常,其中9例为窦性心动过速,3例为ST-T改变；16例病人肺部出现间质性肺病(ILD)表现,并以发热、咳嗽、 Gottron征及抗Jo-1抗体阳性、抗核抗体(ANA)阳性较非间质性肺病组(非ILD)多见,并以此分为ILD组和非ILD组。40例病人中确诊有15例病人合并恶性肿瘤,分别为淋巴瘤5例,鼻咽癌3例,宫颈癌和卵巢癌各2例,乳腺癌、肺癌和胸腺瘤各1例。结论 PM/DM以中老年人为发病高峰人群,女性病人更为多见。临床表现以皮疹、瘙痒及乏力最为常见。血清肌酶是诊断PM/DM的重要指标之一。肌电图与皮肤/肌肉活检对PM/DM的诊断具有重要意义。当抗Jo-1抗体阳性、抗核抗体阳性、发热、咳嗽及Gottron征时可作为PM/DM合并间质性肺病的主要预测因素。当病人出现PM/DM且年龄较大时要积极完善相关检查,排除恶性肿瘤合并PM/DM的可能。 |
| 英文摘要: |
| Objective To improve the correct diagnostic rate of clinicians for polymyositis/dermatomyositis (PM/DM).Methods The clinical data of 40 patients with PM/DM in Guizhou Medical University Affiliated Hospital from December 2012 to January 2017 were retrospectively analyzed.Results There were 40 patients with PM/DM,including 26 female patients and 14 male patients.The clinical manifestations of the Heliotrope rash,pruritus and fatigue were the most common.The most common laboratory examination result was the increase in serum creatine kinase (CK).Electromyography was performed in 33 of 40 patients,and there were 28 cases (84.85%) had myogenic damage in different parts.Muscle biopsy was performed in 18 of 40 patients,and 15 cases (84.00%) showed that the skin/muscle inflammatory change was consistent with “PM/DM” performance.There were 12 cases with abnormal electrocardiographic (ECG),including 9 cases of sinus tachycardia and 3 cases of ST-T change in 40 patients with PM/DM.There were 16 cases with interstitial lung disease (ILD),and the symptoms of fever,cough,Gottron's sign,anti-Jo-1 antibody positive and antinuclear antibody (ANA) positive were more common than those with non-interstitial lung disease (NILD).There were 15 cases with combined malignant tumor,including lymphoma in 5 patients,nasopharyngeal carcinoma in 3 cases,cervical cancer in 2 cases;ovarian cancer in 2 cases,breast cancer in 1 case,lung cancer in 1 case,and thymic tumor in 1 case,respectively.Conclusions PM/DM has the peak incidence in the middle-aged and elderly people,and is mostly found in females.Clinical manifestations of skin rashes,pruritus and fatigue are most common.One of the important indexes for diagnosis is serum creatine kinase.Electromyography and skin/muscle biopsy are of great significance in the diagnosis of PM/DM.Anti-Jo-1 antibody positive,ANA positive,fever,cough,and Gottron's sign are major predictive factors for PM/DM with ILD.When elderly people have PM/DM,we should take active measures to exclude the possibility of malignant tumor combined with PM/DM. |
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