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目的 了解在炎性肌病中肌纤维内脂滴增多的发生频率、影响因素及临床意义。方法回顾性分析53例多发性肌炎和皮肌炎患者的临床病理资料,通过油红O染色显示肌纤维脂滴,依据肌纤维内脂滴的含量将患者分为大致正常和明显增多两组,比较各组患者肌力、肌酶谱、肌肉组织病变程度、病程和用皮质类固醇治疗情况。结果 在53例肌肉标本中, 37 7%有脂滴明显增多。与脂滴正常组相比,脂滴明显增多组肌纤维坏变程度和临床肌力下降程度差异有统计学意义。虽然用激素治疗患者出现脂滴明显增多的几率增加,但无统计学意义。结论 部分肌炎患者有肌纤维内脂滴增多,主要与肌纤维病变有关,细胞能量代谢的异常又可能促进肌纤维的病变,加重肌肉无力。
Objective To understand the frequency, influencing factors and clinical significance of the increase of lipid droplets in myofibers in inflammatory myopathy. Methods The clinical and pathological data of 53 patients with polymyositis and dermatomyositis were retrospectively analyzed. The lipid droplets were observed by oil red O staining. According to the content of lipid droplets in muscle fibers, the patients were divided into two groups: normal and obviously increased. Muscle strength, muscle enzymes, muscular tissue lesions, duration of disease and treatment with corticosteroids in each group. Results In 53 cases of muscle samples, 37.7% of the lipid droplets increased significantly. Compared with the normal lipid droplets group, lipid droplets significantly increased in the group of degree of muscle fiber damage and clinical strength decline was statistically significant. Although there was a significant increase in the incidence of lipid droplets in hormone treated patients, there was no statistical significance. Conclusion Some myositis patients have intramuscular lipid droplets increased, mainly associated with muscle fiber lesions, abnormal cell energy metabolism may promote muscle fiber lesions, aggravating muscle weakness.