皮肌炎的早期诊断和内脏损伤早期识别

Early diagnosis of dermatomyositis and early recognition of visceral injury

皮肌炎是一种临床常见的自身免疫性疾病,常有肌肉和肺的累及,也常合并恶性肿瘤,肺累及常是致命性的。因此,早期诊断及治疗,对减少肌肉和肺的损伤、识别和诊治合并的恶性肿瘤、提高患者预后和生存率有极大帮助。皮肌炎的异质性强,临床表现多种多样,本文论述皮肌炎合并急性肺间质性纤维化、发生吞咽困难、合并恶性肿瘤的高风险因素,总结出“皮疹+甲皱血管+肌炎抗体”的联合模式有助于早期诊断皮肌炎,早期识别重要内脏损害风险和肿瘤,早期干预,提高患者的整体生存率。

Dermatomyositis,a common autoimmune disease in clinical practice,often involves muscles and lungs,and can be complicated by malignant tumors,and the lung involvement can be fatal.Therefore,early diagnosis and treatment of dermatomyositis is of great benefit for the reduction of muscle and lung injury,early recognition and management of malignant tumors,and improvement of prognosis and survival rate of patients.However,the heterogeneity and various clinical manifestations of dermatomyositis pose challenges to early diagnosis.This article describes risk factors for dermatomyositis complicated by rapidly progressive pulmonary interstitial fibrosis,dysphagia or malignant tumors,and proposes a mode of"rashes+nailfold capillary abnormalities+myositis antibodies"for the early diagnosis of dermatomyositis,early recognition of important visceral injury and tumors,and early management,in order to improve overall survival rate of patients.