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目的 研究特发性肌炎临床及肌活检病理的特点。方法 对86例多发性肌炎,41例皮肌炎患者的临床、肌电图、血清肌酶及经开放性手术获得肌活检标本的病理特点进行分析。结果 特发性肌炎:(1)近端肌无力88.9％,远端肌无力62.2％,吞咽困难37.8％,颈肌无力18.1％,肌痛27.6％。(2)肌活捡病理:坏死63.8％,萎缩37.8％,再生35.4％,间质炎23.6％,束周萎缩11.8％。结论 多发性肌炎和皮肌炎临床症状、肌电图、血清肌酶等除皮损外,无很大差异,诊断特发性肌炎肌肉活检是重要手段;束周萎缩为皮肌炎的特征性的病理改变;肌痛虽是特发性肌炎较为特征临床表现,但仅见于部分患者。
Objective To study the clinical and myopathic features of idiopathic myositis. Methods The clinical, electromyogram, serum creatinine and histopathological features of muscle biopsy specimens from 86 patients with polymyositis and 41 patients with dermatomyositis were analyzed. Myopathic myositis: (1) 88.9% of proximal muscular weakness, 62.2% of distal muscular weakness, dysphagia 37.8%, 18.1% of muscular weakness, muscular pain 27.6%. (2) muscle biopsy pathology: necrosis 63.8%, atrophy 37.8%, 35.4% regeneration, interstitial 23.6%, pericardium shrink 11.8%. Conclusions The clinical symptoms, EMG and serum creatinine of polymyositis and dermatomyositis were not significantly different except for skin lesions. Muscle biopsy was an important method to diagnose idiopathic myositis. Sexual pathological changes; although muscle myopathy is a more characteristic clinical manifestations of myotonia, but only seen in some patients.