多发性肌炎与皮肌炎的临床病理研究

摘要

Objective　To study the pathology, the pathogenesis, the effect of treatment and the prognosis of polymyositis and dermatomyositis. Method　Of 58 cases with polymyositis and dermatomyositis were devided into four subgroups according to Bohan's classification.All the patients were inspected the serum emzymes, muscular pathology and the effects of treatment were observed. Results　Although the common symptoms like muscle weakness, myosalgia, elevation of serum emzymes,abnormal electromyography and muscular pathology were presented in those patients,there were some differences in clinic and muscle pathology among those subgroups,which might be due to a different pathogenesis.On therapy,the corticosteroid was the first choice,and the immunoinhibitor should be added if necessary. Conclusion　 The prognosis was closely relevant to the timing of the treatment.The earlier, the better.The symptoms were improving while the serum enzymes decreased.Pulmonary inflammation, cardiac muscle lesion and deferment of course of those diseases indicated that the prognosis was not good.%目的　探讨多发性肌炎和皮肌炎的病理变化、发病机制、治疗效果和预后。方法　按照Bohan的多发性肌炎和皮肌炎的诊断分类标准，将本研究中的58例多发性肌炎和皮肌炎患者分成4类亚型。对全部患者进行肌肉病理及血清酶学检查，并进行治疗观察。结果　临床表现以肌无力、肌肉压痛、血清酶谱增高、肌电图及病理学异常等为特征，但各型之间又有差异，提示存在不同的发病机制。治疗以激素为主，必要时加用免疫抑制剂。结论　预后与治疗时机密切相关。症状随血清酶谱下降而好转。肺部感染、心肌病损及病程迁延提示预后不良。