皮肌炎57例临床分析

Clinical analysis of 57 patients with dermatomyositis

目的探讨皮肌炎(DM)的临床特点、诊断及治疗。方法按照世界卫生组织(WHO)对皮肌炎的诊断标准,对57例DM患者资料进行回顾性分析。结果DM以女性多见,多以皮损为首发症状,部分合并其它系统的损害,少数合并恶性肿瘤、重叠综合征、丙型肝炎病毒感染。肌酶活性早期多升高,病情好转后下降。本组肌电图的检出率为80%,肌肉活检的检出率为100%,皮肤活检的检出率为80%;激素治疗的有效率为94.74%。结论DM是一组以皮肤损害和肌无力为主要表现的自身免疫性疾病。本病的诊断应结合临床资料、肌酶、肌电图、抗Jol抗体等,皮肤肌肉活检可以确诊。治疗以激素为主。

Objective To explore clinical characters, diagnosis and therapy of dermatomyositis （DM）. Methods According to the diagnostic criteria to DM of WHO,medical records of 57 patients with DM were reviewed retrospectively. Results Women were more frequently affected than men. Skin lesion was the initial complaint in most cases. Other systems were involved in some cases. Minority cases showed malignant tumors,overlap syndrome and chronic HCV hepatitis infections. Elevated serum creatine kinase levels were found in 77.19% patients. CK levels decreased when the manifestation improved. 80 % electromyography in 10 patients Were abnormal. The prominent feature was myogenic lesions. The abnormal opportunity of muscular biopsy is 100% in the group, and that of skin biopsy is 80% ,the efficiency of corticosteroid therapy is 97.74%. Conclusion DM is a kind of autoimmune disease which main characters are skin lesion and muscle weakness. Clinical information,serum creatine kinase levels,together with EMG and anti-Jo1 antibody can make diagnosis. Skin and muscular biopsy are strongly recommended if condition permits. Conventional corticosteroid is effective for DM.