摘要
对1990年～1996年间明确诊断的风湿性多肌痛(PMR)20例临床资料进行了回顾性分析。认为凡年龄≥50岁、出现晨僵(80％)、四肢肢带肌僵痛(80％)、乏力(70％)、发热(20％)及体重减轻(>5kg)、血沉≥50mm/1h者,可拟诊为原发性PMR,即投予小剂量强的松(10mg/d)。若在数日内临床症状明显改善或缓解者,更有利于诊断,但需注意排除颞动脉炎、多发性肌炎及肿瘤等所致的继发性PMR。
To fully understand the clinical features of patients with polymyalgia rheumatica (PMR), the clinical manifestations, diagnosis and differential diagnosis of 20 cases during 1990-1996 were retrospectively studied. Most patients were older than 50 years with the following clinical and laboratory features: morning stiffness (80%), pain of the muscles of shoulder, neck and pelvic girdles (80% ), malaise (70% ), fever (20% ), marked weight loss ( >5kg) and high ESR (≥50mm/1h). The patients with clinical features mentioned above should be suspected. However the definite diagnosis of primary PMR could only be made in patients who are very sensitive to the therapy of lower dosage of prednisone (10mg/d) in several days. At the same time the PMR secondary to temporal arteritis, polymyositis and malignancies should also be excluded.
