皮肌炎重叠系统性硬化症心脏损害1例并临床探讨

A case of dermatomyositis overlap systemic sclerosis with cardiac damage and clinical investigation

皮肌炎以对称性近端肌无力为特征,常同时累及其他器官,多伴有血清肌酶升高及肌电图异常,合并心血管病变为其死亡危险因素之一,但临床上明显的心脏受累较为罕见,也可能是合并心脏受累的情况尚未得到重视。系统性硬化症具有复杂的发病机制和多样性的临床表现,在疾病表现上具有广泛异质性,临床表现主要以雷诺现象,皮肤受累如指端硬化、弥漫性皮肤改变,肠道动力障碍,以及心、肺、肾等脏器受损。皮肌炎重叠系统性硬化症在临床上常见,心脏损害为其重要的死亡原因之一,本文通过回顾潍坊市中医院1例皮肌炎重叠系统性硬化症导致心肌损害患者的病例资料,通过分析其临床特点,治疗转归等,并检索万方数据、知识平台PubMed、中国知网等国内外权威数据库搜索相关文献,分析、归纳其特点,从而加强临床医师对疾病的认知,提高警惕,通过早期检查、诊断以及综合治疗改善患者预后。

Dermatomyositis is characterized by symmetric proximal muscle weakness,often involving other organs at the same time,mostly accompanied by elevated serum myocardial enzymes and abnormal electromyogram,combined with cardiovascular disease is one of the risk factors for death,but clinically obvious cardiac involvement is rare,and it may be that the situation of combined cardiac involvement has not been paid attention to.Systemic sclerosis has complex pathogenesis and diverse clinical manifestations,and has wide heterogeneity in disease manifestations.The main clinical manifestations are Raynaud's phenomenon,skin involvement such as finger sclerosis,diffuse skin changes,intestinal motility disorders,and heart,lung,kidney and other organs damage.Dermatomyositis overlap with systemic sclerosis is common in clinic,and cardiac damage is one of the important causes of death.This paper retrospectively analyzed the case data of 1 patient with dermatomyositis overlap with systemic sclerosis causing myocardial damage in Weifang Hospital of Traditional Chinese Medicine,analyzed its clinical characteristics,treatment outcomes,and searched Wanfang data,PubMed,CNKI and other authoritative databases at home and abroad to search for relevant literature,analyzed and summarized its characteristics,so as to strengthen the cognition of clinicians on the disease,increase vigilance,and improve the prognosis of patients through early examination,diagnosis and comprehensive treatment.