散发性包涵体肌炎临床病理分析  

Clinical and pathological features of sporadic inclusion body myositis

作　　者：王敏[1] 笪宇威[1] 卢岩[1] 徐敏[1] 刘璐[1] 贾建平[1] 

机构地区：[1]首都医科大学宣武医院神经内科,北京100530

出　　处：《脑与神经疾病杂志》2011年第5期389-392,共4页Journal of Brain and Nervous Diseases

摘　　要：目的探讨散发性包涵体肌炎(sIBM)患者的临床及病理特点。方法收集2例于2008年至2010年就诊并明确诊断为s1BM的患者临床、病理资料。两例患者均有股四头肌无力和萎缩,1例出现肢体远端无力和上肢无力。2例患者均进行了肌肉活体组织检查标本的组织学、酶组织化学染色和免疫组织化学染色。结果 2例患者肌酶均轻度升高。肌电图检查示1例呈肌源性损害,1例呈神经源性损害。2例患者的骨骼肌主要病理改变都是肌内衣炎细胞浸润、肌纤维萎缩,肌纤维内嗜碱性镶边空泡。免疫组织化学染色提示CD8+淋巴细胞浸润为主,1例患者镶边空泡肌纤维内Ubiquitin染色阳性。结论本文2例sIBM以股四头肌损害明显,病情缓慢进展,依靠肌肉活检确定诊断。Objective To investigate the clinical and pathological features of sporadic inclusion body myositis(sIBM).Methods Clinical manifestations and pathological features of biopsied muscle specimens were summarized and analyzed retrospectively.Muscle specimens were collected from quadriceps femoris and observed by light microscope.Results Both patients developed progressive weakness of quadriceps.Serum creatine kinase levels were mildly.Electromyography showed myogenic changes in one patient and neurogenic changes in another one. Endomysial inflammation,atrophy of muscle fiber,rimmed vacuoles were found in both patients.Endomysial inflammatory cell infiltrates mostly composed of macrophages and CD8+ cytotoxic/suppressor T lymphocytes.Ubiquitin staining was positive in one patient.Conclusion The clinical and pathological findings of sIBM show that the quadriceps is often involved.The histological examination plays an important role in the diagnosis of sIBM.

关 键 词：肌炎 包涵体 活组织检查 

分 类 号：R746[医药卫生—神经病学与精神病学]