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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:AST 61.0%,CPK 50.7%,LDH 59.2%。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。
In order to explore the clinical manifestations of dermatomyositis, treatment response and the relationship with malignant tumors, the clinical data of 86 cases of dermatomyositis were retrospectively analyzed. In 86 cases, there were 21 males and 65 females, with a ratio of 1: 3.1. Age 75% of the onset of 20 to 60 years old. Initial symptoms of dermatitis (51.2%) and dermatitis concurrent (44.2%) more common. Skin damage More than edema edema edema (84.9%), Gottron papules (59.3%), skin disorders (61.6%) and erythema of the week (41.9%) were more common. Muscle involvement in the proximal upper limb (80.2%), lower extremity (79.1%) and esophagus (31.4%) more common. Serum muscle enzymes increased frequency: AST 61.0%, CPK 50.7%, LDH 59.2%. 24-hour urinary creatine excretion increased to 70.8%. 86.5% of patients EMG showed myogenic damage. 6 patients with visceral malignancy, 5 patients with interstitial pneumonia. Most patients respond well to corticosteroids and corticosteroids in combination with methotrexate. Four patients died of malignant tumors, three died of corticosteroid side effects and one died of unrelated disease.