皮肌炎合并急性间质性肺炎七例临床分析并文献复习  

Clinical analysis of 7 dermatomyositis cases with acute interstitial pneumonia and literature review

作　　者：魏强华[1] 金毓莉[1] 杨虎天[1] 周新[2] 

机构地区：[1]上海交通大学附属第一人民医院风湿专科,200080 [2]上海交通大学附属第一人民医院呼吸科,200080

出　　处：《中华风湿病学杂志》2007年第5期301-303,共3页Chinese Journal of Rheumatology

摘　　要：目的分析皮肌炎合并急性间质性肺炎的临床特点,探讨发病原因,提高治疗水平。方法对我院1997—2005年收治的7例皮肌炎合并急性间质性肺炎患者进行回顾性分析,并复习相关文献。结果7例患者都有典型皮肌炎皮疹,但肌炎症状轻微。在确诊皮肌炎的同时或短期内合并出现高热、气急、干咳,胸片和胸部CT提示多发的片状肺间质改变,并且迅速进展。抗感染和大剂量甲泼尼龙治疗无效,7例患者全部死亡。结论急性间质性肺炎可能是无肌病皮肌炎或肌病轻微皮肌炎的肺部表现。为改善本组患者的预后,应尽早诊断,加强学科合作,制定更为合理有效的治疗方案。Objective To analysis the clinical features of dermatomyositis （DM） complicated with acute interstitial pneumonia （AIP）, and to explore the cause of the disease to improve the treatment. Methods Seven cases of dermatomyositis complicated with AIP in our hospital from 1997 to 2005 were studied retrospectively and the literatures were reviewed. Resets Seven dermatomyositis patients had typical cutaneous vasculitis with slight symptom of myositis. The electromyogram showed myogenic damage. The Jo-I antibodies were all negative. Simultaneously or shortly after the diagnosis of dermatomyositis, all patients presented with high fever, dry cough and progressed dyspnea. The chest X-ray or high-resolution computed tomography displayed diffuse pulmonary interstitial changes which progressed rapidly. All patients died despites anti-infectious treatment and high dose steroid therapy. Conclusion AIP is the pulmonary injury of amyopathic or hypomyopathic dermatomyositis. In order to improve the prognosis, early diagnosis should be emphasized and interdisciplinary cooperation should be strengthened.

关 键 词：皮肌炎 诊断 治疗 间质性肺炎 急性 

分 类 号：R593.26[医药卫生—内科学] R563.1[医药卫生—临床医学]