多发性肌炎和皮肌炎临床特点分析

摘要/Abstract

摘要： 目的: 对比分析多发性肌炎(PM)和皮肌炎(DM)的临床特征,提高临床认识、改善预后。方法: 收集2006年8月至2009年8月间住院的PM和DM患者共32例,对其年龄、住院时间、肌力、血清肌酸磷酸激酶(CPK)水平、红细胞沉降率(ESR)、C反应蛋白(CRP)和股四头肌MRI、肺高分辩率CT(HRCT)进行比较分析。结果: DM组和PM组患者在年龄、肱二头肌力、股四头肌力、住院时间、ESR、CRP方面差异均无统计学意义(P>0.05)。CPK水平PM组(3032±2973)U/L显著高于DM组(390±947) U/L,差异有统计学意义(P=0.015)。DM和PM患者颈肌受累、吞咽困难、声音嘶哑等方面,差异无统计学意义(P>0.05)。DM组间质性肺炎(ILD)的发生率显著高于PM组患者(P=0.021),且MRI上水肿信号的改变比PM患者明显。PM组对糖皮质激素疗效显著优于DM组(P=0.013)。4例死亡均为DM患者,3例死于间质性肺炎合并感染后呼吸衰竭,1例死于横纹肌溶解综合症致急性肾功能衰竭。结论: DM患者CPK水平不及PM患者高,但并发ILD较多,预后较PM差。

关键词: 多发性肌炎, 皮肌炎, 预后

Abstract: AIM: To study the difference of clinical charactertics between polymyositis and dermatomyositis patients.METHODS: 11 cases of polymyositis and 21 cases of dermatomyositis were included in this study.Their muscle strength, serum creatine phosphokinase (CPK) levels, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), hospitalization times, the quadriceps muscle MRI and high-resolution lung CT (HRCT) were compared.RESULTS: There were no statistic differences among muscle strength, ESR, CRP, hospitalization times, hoarseness and dysphagia in the two groups(P>0.05).The level of CPK in polymyositis patients was significantly higher than that in dermatomyositis patients [(3032±2973)vs(390±947) U/L(P=0.015)]. But the rate of incidence of interstitial pneumoniin in dermatomyositis patients was significantly higher than that in polymyositis patients (P=0.021),and the therapy effect of glucocorticoids in polymyositis patients was significantly better than that in dermatomyositis patients (P=0.013). 4 deaths were all dermatomyositis patients,3 cases died with interstitial pneumoniin developed respiratory failure and 1 cases died with rhabdomyolysis developed acute renal failure.CONCLUSION: The level of CPK in dermatomyositis patients is higher than polymyositis patients, but more complicated that in by interstitial pneumoniin and poor prognosis.

Key words: Polymyositis, Ermatomyositis, Prognosis

中图分类号:

R593

宣丹, 盛君, 李志, 毛桐俊, 徐亮, 陆进明. 多发性肌炎和皮肌炎临床特点分析[J]. 中国临床药理学与治疗学, 2011, 16(5): 558-562.

XUAN Dan, SHENG Jun, LI Zhi , MAO Tong-jun, XU Liang , LU Jin-ming. Compare study of clinical features in polymyositis and dermatomyositis[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2011, 16(5): 558-562.

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