特发性炎症性肌病肌肉病变的诊断及活动度评估

Diagnosis and Mobility Assessment of Muscle Involvement in Idiopathic Inflammatory Myopathies

特发性炎症性肌病(idiopathic inflammatory myopathies,IIMs)是一组以肌肉炎症为特征的异质性疾病,常有皮肤、肺和关节等多器官受累。因累及的肌群不同,给患者带来的影响也不甚相同,累及四肢骨骼肌导致肌无力,累及心肌和呼吸肌出现心衰和呼吸困难,甚至危及生命。因此,早期诊断肌肉病变和评估病变活动度,有助于准确及时治疗和判断预后。近年来,许多生物标记物已被确定为诊断、疾病亚型、预后或反应治疗效果的有用指标。本文回顾了影像检查方法与血清和肌肉组织中生物标记物的意义,重点介绍它们在IIMs肌肉病变方面的诊断、评估和预后价值。

Idiopathic inflammatory myopathies,characterized by muscle inflammation,are a heterogeneous acquired myopathy,and often accompanied by extramuscular manifestations affecting the skin,lungs and joints.The different muscle involved have different impacts on the life of patients.Limbs muscle involved cause muscle weakness,while cardiac muscle and expiratory or inspiratory muscle involved may induce heart failure and dyspnea,which are life-threatening complications.Therefore,early diagnosis of muscle lesions and mobility assessment have great significance to the treatment and prognosis.In recent years,many biomarkers have been identified as useful indicators for diagnosis,disease subtypes,prognosis,or response to treatment of IIMs.This article reviews imaging examination method and the significance of biomarkers detection in serum and muscle tissue,focusing on the diagnostic,evaluable and prognostic value in IIMs of muscle involvement.