儿童与成人皮肌炎临床对照分析  

Clinical comparative analysis of juvenile dermatomyositis and adult dermatomyositis

作　　者：余红[1,2] 李春晓[1] 姜承易 程茹虹 黄珮蓁 张珍[1] 赵东宝[3] 

机构地区：[1]上海交通大学医学院附属新华医院皮肤科,上海200092 [2]第二军医大学研究生院临床医学系,上海200433 [3]第二军医大学附属长海医院风湿免疫科,上海200433

出　　处：《临床儿科杂志》2015年第3期234-237,共4页Journal of Clinical Pediatrics

摘　　要：目的探讨儿童与成人皮肌炎临床特点的差别。方法回顾性分析61例儿童皮肌炎患者的临床资料,并与30例成人患者进行比较。结果除1例儿童患者,所有患者首发症状均为皮疹、面部红斑;儿童患者出现Gottron's丘疹者90%,成人67%;儿童患者钙盐沉积7%;儿童患者累及心血管系统7%,成人为23%;儿童患者无肿瘤发生,成人发生肿瘤13%。儿童和成人患者肌酶阳性检测率高低均依次为LDH、羟丁酸酶、CK-MB、AST、CK;儿童和成人患者磁共振检测阳性率均超过80%。儿童和成人患者中各有2例死亡。结论儿童皮肌炎与成人皮肌炎患者临床表现基本相同,但儿童患者首发症状中皮疹、Gottron's丘疹更多见,心血管病变及恶性肿瘤少见。磁共振检查有助于皮肌炎的诊断。Objective To understand the difference in characteristics between juvenile dermatomyositis（JDM） and adult dermatomyositis（ADM）.Methods Sixty-one cases of JDM were retrospectively analyzed and compared with 30 cases of ADM.Results The rashes were presented as the initial symptom in all expect one JDM patients.Gottron＇s papules were presented in 90% JDM patients and 67% ADM patients.Calcium deposition was presented in 7% JDM patients and none of the ADM patients.The cardiovascular system was involved in 7 % JDM patients and 23% ADM patients.Cancer occurred in none of JDM patients and 13% ADM patients.In JDM and ADM patients,the ratio of elevated muscle enzymes from highest to lowest was LDH,hydroxybutyric acid enzyme,CK-MB,AST,and CK.The positive ratio of magnetic resonance（MRI） all exceeded 80% in JDM and ADM groups.Two cases died in each group.Conclusions The clinical presentation of JDM is basically the same as that of ADM.The most common initial symptoms in JDM are skin rashes and Gottron＇s papules.Cardiovascular disease and cancer are less in JDM than in ADM.MRI is valuable in the diagnosis of DM.

关 键 词：皮肌炎 临床特点 儿童 

分 类 号：R725.9[医药卫生—儿科] R593.26[医药卫生—临床医学]