皮肌炎和多发性肌炎肌肉微血管病变的病理和免疫病理改变  

Pathological and immunopathological changes of skeletal muscle microvessels in dermatomyositis and polymyositis

作　　者：代丽美[1] 陈爱明[1] 王彩梅[1] 杨玉花[1] 

机构地区：[1]苏州大学附属第一医院皮肤科, 江苏215006

出　　处：《中华皮肤科杂志》2012年第10期711-713,共3页Chinese Journal of Dermatology

摘　　要：目的探讨皮肌炎（dermatomyositis，DM）的肌肉病理特征、肌纤维间的微血管改变以及与多发性肌炎（polymyositis，PM）肌肉病理的差异。方法对16例DM和5例PM患者行肌肉活检，9例健康人骨外伤患者为对照组，做常规组织病理学检测和免疫组化染色（CD34、CD61）。结果37．5％DM患者有束周萎缩，肌纤维问微血管周围有较明显炎症细胞浸润的为18．8％，而PM及正常组的肌肉中未见束周萎缩。DM患者肌纤维间CD34标记的微血管数明显减少，而PM正常；16例DM中5例CD61呈阳性表达（束周区），5例为弱阳性，阳性率为62．5％；PM仅1例呈弱阳性；正常对照组为阴性。结论肌纤维问的微血管减少和新生血管形成也是DM肌肉病变的特征之一，该特征可用于DM与PM肌肉病理的鉴别。Objective To assess pathological features of muscles as well as microvascular changes between muscle fibers in patients with dermatomyositis （DM）, and to analyze pathological differences in muscles between DM and polymyositis （PM）. Methods Specimens were obtained from involved muscles of 16 patients with DM, 5 patients with PM, and from normal muscles of 9 patients with bone trauma （controls）. Routine histopathological examination and immunohistochemieal staining for CD34 and CD61 were conducted. Results Of the 16 patients with DM, 6 （37.5%） had perifascicular atrophy, 3 （18.8 %） had an obvious inflammatory cell infiltration around mierovessels between muscle fibers. Perifascieular atrophy was absent in muscle specimens from patients with PM or bone trauma. The number of CD34-positive microvessels between muscle fibers was reduced in patients with DM, but normal in those with PM. CD61 was positive in perifaseicular area of 10 patients （5 moderately positive and 5 weakly positive） with DM, with an expression rate of 62.5%, however, only 1 ease of PM was weakly positive for CD61, and all the controls were negative. Conchlsions There is a decrease in the number of mierovessels but an enhancement of neovaseularization between muscle fibers in involved museles of patients with DM, which may serve as a pathological marker to distinguish DM from PM.

关 键 词：皮肌炎 病理过程 血管疾病 肌疾病 

分 类 号：R593.26[医药卫生—内科学]