系统性红斑狼疮伴肌炎的临床研究

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1、系统性红斑狼疮伴肌炎的临床研究屮华皮肤科朵志1999年第1期第32卷论著作者：朱晓浚林宝珠郭庆陈明春曾凡钦谭国珍单位：朱晓浚林宝珠郭庆陈明春曾凡钦谭国珍(510120广州，中山医科大学孙逸仙纪念医院皮肤科)关键词：红斑狼疮；系统性；皮肌炎【摘要】目的探讨系统性红斑狼疮(SLE)伴肌炎患者的临床特点及其意义。方法采用对照研究方法，检测了64例SLE伴肌炎患者和43例皮肌炎(DM)患者的血清肌酶、肌电图、肌肉活检等，并做统计学分析。结果SLE肌炎的发生率为35.5%,症状轻，有轻度肌萎缩；与DM比较肌无力不明显(P<0.01)；未见吞咽困难；SLE伴肌炎患者病

2、情活动发生¥[75%(48/64)]高于非肌炎纽.[43.9%(29/66)],有显著性差界(P<0.01)；肌酶有所升高，但升高幅度均不超过止常值的50%,与DM患者比较有显著性差异(PV0.01)；肌电图肌炎检出率为74.4%(32/43),与DM组81.4%(35/43)比较无显著性差异(P>0.05)；肌活检显示：肌间质血管炎，淋巴细胞和组织细胞浸润明显；肌纤维灶性肿胀，匀质变性，横纹模糊，未见坏死断裂，病变轻微。结论SLE肌炎较为常见，与SLE活动相关，症状轻，肌酶升高幅度小；肌电图与DM无异；肌活检间质病变明显，肌纤维病变轻微，有明显的临床和病

3、理特征而有别于DMoClinicalStudyonthePatientswithSystemicLupusErythematosusAssociatedwithMyositisZHUXiaojun,LINBaozhu,GUOQing,etal.DepartmentofDermatology,SunYat-SenMemorialHospital,Guangzhou510120[Abstract]ObjectiveTostudytheclinicalfeaturesandsigificanceofsystemiclupuserythemato

4、sus(SLE)patientsassociatedwithmyositis.MethodsAcomparativestudyof64casesofsystemiclupuserythematosus(SLE)associatedwithmyositisand43casesofdermatomyositis(DM)wasearnedoutbytheobservationofclinicalfeatures,serumlevelsofmuscleenzymes,electromyographicpatternandmusclebiopsies.Results

5、Theresultsshowedtherewere35.5%ofpatientswithSLEassociatedwithmyositis.Themyositissymptoms,muscleweaknessandatrophyinthesepatientswerelesssignificantthanthoseofDM(P<0.01).Theabnormalesophagealmotilitywasnotseeninthesepatients.AlthoughtheserumlevelofmuscleenzymesinSLEpatientswithmyo

6、sitiswaselevated,thelevelwassignificantlylowerthanthatofDMpatients(P<0.01)・Electromyographicabnormalityaccountedfor74.4%(32/43)ofSLEpatientswithmuscleinvolvement,andthedifferencewasnotsignificantfromthatofDMpatients(P>0.05).Musclebiopsyshowedthattherewereobviousinterstitialvasculi

7、tiswithinfiltrationoflymphocytesandhistiocytes,focalswellingandhomogeneousdegenerationofmucsclefibers,andnonecrosisfragmentationwasobserved.ConclusionSLEmyositishasitsdistinctclinicalandpathologicalcharacteristicswhicharedifferentfromthoseofDM.[Keywords]Lupuserythematosis,systemic

8、Dennatomyositis系统性红斑狼疮(SLE)是一种多器©