中华皮肤科杂志 ›› 1997, Vol. 30 ›› Issue (1): 10-12.

• 论著 • 上一篇    下一篇

皮肌炎86例分析

张建中, 薛树旗, 马圣清   

  1. 北京医科大学第一医院皮肤科, 100034
  • 收稿日期:1996-04-02 修回日期:1996-07-23 出版日期:1997-02-15 发布日期:1997-02-15

Clinical and Laboratory Study of 86 Patients with Dermatomyositis

Zhang Jianzhong, Xue Shuqi, Ma Shengqing   

  1. Department of Dermatology. The First Hospital, Beijing Medical University, Beijing 100034
  • Received:1996-04-02 Revised:1996-07-23 Online:1997-02-15 Published:1997-02-15

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摘要： 为了探讨皮肌炎的临床表现、治疗反应及与恶性肿瘤的关系,回顾性分析了86例皮肌炎的临床资料.86例中,男21例,女65例,男女之比为1:3.1.发病年龄75%在20～60岁之间.初发症状以皮炎(51.2%)和皮炎肌炎同时发生(44.2%)多见.皮肤损害以上眼睑紫红色浮肿性红斑(84.9%)、Gottron丘疹(59.3%)、皮肤异色症(61.6%)及甲周红斑(41.9%)多见.肌肉受累以上肢近端(80.2%)、下肢近端(79.1%)和食道(31.4%)多见.血清肌酶升高频率为:AST61.0%,CPK50.7%,LDH59.2%.24小时尿肌酸排泄增高为70.8%.86.5%患者肌电图呈肌源性损害.6例患者合并内脏恶性肿瘤,5例合并间质性肺炎.绝大多数患者对皮质类固醇及皮质类固醇与甲氨喋呤合用反应良好.4例患者死于恶性肿瘤,3例死于皮质类固醇激素的副作用,1例死于无关疾病.

关键词: 皮肌炎, 恶性肿瘤

Abstract: Dermatomyositis (DM) is an inflammatory connective tissue disease of unknown cause. To investigate its clinical manifestation, treatment response and the relationship to internal malignancies, 86 patients with DM were retrospectively analyzed. DM was seen predominantly in women with a ratio of male to female 1:3.1. The age of onset of 75% of the patients was between 20 to 60.51.2% of the patients with skin lesions manifested as first presentation and 44.2% with simultaneous skin and muscte diseases. The mostly seen skin manifestations were heliotrope eruption (84.9%), Gottron's papule (59.3%), poikiloderma (61.6%) and periungual erythema (41.9%). Muscles of upper and lower proximal extremities were mostly involved (80.2% and 79.1% respectively), followed by that of esophagus (31.4%). Increased serum levels of AST (61.0%), CPK (50.7%) and LDH (59.2%) were the main laboratory abnormalities. 70.8% of the patients were found to have increased 24 h creatine excretion. 86.5% patients showed abnormal EMG. Internal malignancies were found in 6 patients. 5 patients had interstitial pneumonia. Most patients responded well to corticosteroid, and in some cases, the combination of corticosteroid and methotrexate. 4 patients died of malignancies, 3 side-effect of the corticosteroid and 1 unrelated disease.

Key words: Dermatomyositis, Malignancies