中华皮肤科杂志 ›› 2012, Vol. 45 ›› Issue (10): 711-713.

• 论著 • 上一篇    下一篇

皮肌炎和多发性肌炎肌肉微血管病变的病理和免疫病理改变

代丽美1,陈爱明2,王彩梅3,杨玉花4   

  1. 1. 威海市妇女儿童医院
    2. 苏州大学附属第一医院
    3. 江苏省苏州市苏州大学附属第一医院皮肤科
    4.
  • 收稿日期:2011-10-21 修回日期:2012-05-09 出版日期:2012-10-15 发布日期:2012-09-29
  • 通讯作者: 陈爱明 E-mail:amchen0829@sina.com

Pathological and immunopathological changes of skeletal muscle microvessels in dermatomyositis and polymyositis

  • Received:2011-10-21 Revised:2012-05-09 Online:2012-10-15 Published:2012-09-29

摘要:

目的 探讨皮肌炎 (dermatomyositis,DM)的肌肉病理特征、肌纤维间的微血管改变以及与多发性肌炎(polymyositis,PM)肌肉病理的差异。方法 对16例DM和5例PM患者行肌肉活检,9例健康人骨外伤患者为对照组,做常规组织病理学检测和免疫组化染色(CD34、CD61)。 结果 37.5%DM患者有束周萎缩,肌纤维间微血管周围有较明显炎症细胞浸润的为18.8%,而PM及正常组的肌肉中未见束周萎缩。DM患者肌纤维间CD34标记的微血管数明显减少,而PM正常;16例DM中5例CD61呈阳性表达(束周区),5例为弱阳性,阳性率为62.5%;PM仅1例呈弱阳性;正常对照组为阴性。结论 肌纤维间的微血管减少和新生血管形成也是DM肌肉病变的特征之一,该特征可用于DM与PM肌肉病理的鉴别。

关键词: CD61

Abstract:

Objective To assess pathological features of muscles as well as microvascular changes between muscle fibers in patients with dermatomyositis (DM), and to analyze pathological differences in muscles between DM and polymyositis (PM). Methods Specimens were obtained from involved muscles of 16 patients with DM, 5 patients with PM, and from normal muscles of 9 patients with bone trauma (controls). Routine histopathological examination and immunohistochemical staining for CD34 and CD61 were conducted. Results Of the 16 patients with DM, 6 (37.5%) had perifascicular atrophy, 3 (18.8 %) had an obvious inflammatory cell infiltration around microvessels between muscle fibers. Perifascicular atrophy was absent in muscle specimens from patients with PM or bone trauma. The number of CD34-positive microvessels between muscle fibers was reduced in patients with DM, but normal in those with PM. CD61 was positive in perifascicular area of 10 patients (5 moderately positive and 5 weakly positive) with DM, with an expression rate of 62.5%, however, only 1 case of PM was weakly positive for CD61, and all the controls were negative. Conclusions There is a decrease in the number of microvessels but an enhancement of neovascularization between muscle fibers in involved muscles of patients with DM, which may serve as a pathological marker to distinguish DM from PM.

Key words: CD61

中图分类号: 

  • R75