无肌病性皮肌炎15例临床分析.pdfVIP

66 2008 14 2 15 华中科技大学同济医学院附属同济医院 雷小妹 李守新 胡绍先, 武汉 43 0030 目的: 探讨 肌病性皮肌炎( A DM) 的临床特征诊断治疗和预后, 提高临床医师对A DM 的诊治水平 方法: 将89 例患者分为2 组, 其中有Gottron 丘疹, 或有眶周水肿性淡紫色斑疹, 而临床缺乏明显肌炎者 15 例为 ADM 组, 皮肌炎组( DM 组) 74 例分别记录其临床特征肌酸激酶肌电图肌肉病理检查胸部影像学检查器官 受累情况治疗方案和转归结果: ADM 组关节痛发热继发肺间质炎症和抗Jo- 1 抗体阳性的发生率分别为 4 0% 13 . 3 % 6 6. 7% 和13. 3 % , 并发肿瘤6. 7 % , 病死率20 % DM 组关节痛发热肺间质炎症和抗Jo- 1 抗体阳性 的发生率分别为37 . 8% 14. 9% 32 . 4% 和 14 . 9 % , 病死率5 . 4 % 二者比较, A DM 组肺间质炎症发生率明显高于 DM 组结论: A DM 组虽然没有明显肌病表现, 但是同样可以累及内脏, 其中肺间质炎症的发生率较高, 联合糖皮 质激素和细胞毒免疫抑制剂治疗可以改善患者预后临床医师需提高对A DM 的认识 肌病性皮肌炎 皮肌炎 间质性肺炎 593. 2 6 A Clinical Analysis of 15 Cases With Amyopathic Dermatomyositis LE I X iaomei , L I Shoux in, H U Shaox ian . Tongj i H osp ital Af f iliated to Tongj i M edical Colleg e, H ua hong University of S cience and Technology , Wuhan 4 30 03 0, China Abstract Objective: T o investi ate the clinical feat ure, dia nosis, treatment and pro nosis of amyopathic der- matomyositis ( A DM) . Methods: Ei ht y-nine patients w ere divided int o t wo roups: 15 cases with characterist ic skin rash, but normal CK , normal EMG, normal muscle biopsy w ere A DM roup, 74 cases with dermatit is and myosit is were dermatomyositis ( DM) roup. Clinical features, creat inkinase ( CK) , or ans involvement, treat ment and the re- sults of t herapy were recorded. Results: Incidence of joint pain, fever , interstitial lun disease ( ILD) , ant-i Jo-1 w as 4 0% , 13 . 3 % , 6 6. 7% and 13. 3 % in A DM roup respectively . While in DM roup it w as 3 7. 8% , 14. 9% , 32 . 4 % and 14 . 9 % respectively . The mort alit y rate in A DM and DM roup w as 20 % and 5 . 4 % respectively . The prevalence