多发性肌炎、皮肌炎合并肺间质性肺炎的诊治

Diagnosis and Treatment of Polymyositis and Dermatomyositis with Pulmonary Interstitial Pneumonia

多发性肌炎(PM)、皮肌炎(DM)的死亡原因多种多样,合并肺间质性肺炎是其最主要的死亡原因。在合并间质性肺炎的皮肌炎及多发性肌炎患者中,中性粒细胞与淋巴细胞比值、血浆白蛋白与C反应蛋白比值、铁蛋白、IL-6、IL-8、IL-10明显升高,PM/DM患者的肺功能检查常显示弥散功能较差。HRCT是检测肺部间质性疾病的主要手段,不同类型的间质性肺炎影像学表现不同。目前,关于PM/DM合并间质性肺炎患者的治疗尚未明确规定,本文现就多发性肌炎、皮肌炎合并肺间质性肺炎的血清学检查、肺功能检查、影像学表现以及治疗作一综述。

The causes of death in polymyositis(PM)and dermatomyositis(DM)are various.Complicated pulmonary interstitial pneumonia is the main cause of death.In patients with dermatomyositis and polymyositis with interstitial pneumonia,neutrophil to lymphocyte ratio,plasma albumin to C-reactive protein ratio,ferritin,IL-6,IL-8,IL-10 significantly increased,pulmonary function tests in patients with PM/DM often show poor diffuse function.HRCT is the main method to detect pulmonary interstitial disease,and different types of interstitial pneumonia have different imaging manifestations.At present,the treatment of PM/DM patients with interstitial pneumonia has not been clearly defined,this article is a review of polymyositis,dermatomyositis combined with pulmonary interstitial pneumonia serological examination,lung function examination,imaging manifestations and treatment.