多发性肌炎和皮肌炎201例临床病理研究

Clinical and pathological study on 201 patients with polymyositis and dermatomyositis

201例多发性肌炎和皮肌炎,根据Bohan分型标准分成五组类型,其临床上以肢体肌无力、皮肤损害、疼痛、血肌酶升高、肌电图改变、肌活检肌纤维坏死及炎性细胞浸润为特征,但不同类型有所侧重,揭示其发病机制不同。治疗体会仍以激素为首选,必要时加用免疫抑制剂,开始治疗时间不应晚于1.5年,防治肺部感染是改善预后的重要措施之一。

201 cases of polymyositis and dermatomyositis (PM/DM) were divided into five subgroups based on Bohan' classification. Although the common symptoms like muscle weakness, rash, myosalgia, elevation of the serum enzymes such as CPK, necrotic muscle fibers and monocyte infiltration in muscle pathology were present in those patients, some differences in clinic and muscle pathology were observed in those patients by our study, which might be due to a different pathogenesis. On therapy, our study suggested that corticosteroid was of the first choice, and if patients toleranced to it, the immunosuppression should be added. Early treatment (not lated to 1. 5 year after occurence) as well as prevention of respiratioy infection was related to the good prognosis.