多发性肌炎的临床病理与超微结构观察

Chincopathological and ultrastructural studies in polymyositis

报告多发性肌炎、皮肌炎81例。其中46例做肌肉活检,见不同程度肌纤维变性坏死,炎性细胞浸润。11例超微结构观察到淋巴细胞侵入肌纤维基底膜下,肌丝断裂,空泡样变,Z线消失,肌细胞再生。除肌纤维病变外,11例发现血管壁增厚,管腔狭窄甚至闭塞。6例神经活检发现周围神经脱髓鞘及血管内膜增生。提示肌纤维损伤存在不同的病理机制。

This paper is a study of 81 cases of polymyositis. The morphological changes in 46 cases with muscle biopsies showed variable degrees of degeneration, focal necrosis and infiltration of lymphocytes and some plasma cells among muscle fibres. EM from 11 patients confirmed that basal lamina was invaded by lymphocytes. Vacuolar degeneration and disappearance of Z-hand can be seen. Small regenerating fibres were found. In 11 cases thicking of small blood vessel walls, intimal proliferation and partial or total occlusion of the vascular lumen were noted. Peripheral nerve biopsies from 6 cases revealed demyelination. These findings suggest that pathological mechanism resulting in muscle fibre lesion may be varied.