摘要
目的比较皮肌炎(DM)和多发性肌炎(PM)临床表现和实验室检查的异同。方法回顾性分析2012年1月1日至2015年10月31日中国医科大学附属第一医院风湿免疫科收治的62例DM和29例PM患者的临床资料,分析其临床特征的异同。并比较伴有间质性肺病(ILD)的DM和PM患者实验室检查的异同。结果乏力、肌痛、吞咽困难、发热等症状的发生频率在DM和PM组间差异均无统计学意义。DM组外周血淋巴细胞计数为(1.13±0.48)×10~9/L,显著少于PM组的(1.78±0.90)×10~9/L(P=0.01)。DM患者CD3^+T细胞数[(612±332)个/μL对(1543±945)个/μL,P=0.01]、CD4^+T细胞数[(370±175)个/μL对(741±450)个/μL,P=0.02]、CD8+T细胞数[(219±178)个/μL对(738±644)/μL,P=0.02]均显著少于PM组。PM患者CD4+T/CD8+T比值为(2.6±1.5),显著高于DM患者的(1.5±1.0)(P=0.03)。与PM患者相比,DM患者血清白蛋白水平[(34.2±4.7)g/L对(38.1±5.5)g/L,P=0.01]明显降低。伴有ILD的DM(DM-ILD)患者外周血淋巴细胞计数[(1.47±1.04)×10~9/L对(1.70±0.85)×10~9/L,P=0.04]、血清肌酸激酶水平显著低于伴有ILD的PM患者(PM-ILD)[(1220.8±2118.5)U/L对(3150.8±2965.9)U/L,P=0.02]。DM-ILD患者CD4^+T/CD8^+T比值为2.3±1.4,显著高于PM-ILD患者的1.4±0.4(P=0.00)。结论 DM和PM在临床症状上具有一定相似点,但外周血T细胞总数及不同亚群计数却存在显著差异,提示免疫失衡在DM患者的发病机制中具有重要作用。
Objective To investigate the differences of clinical presentation and laboratory data between dermatomyositis （DM） and polymyositis （PM）. Methods Retrospective analysis was conducted on sixty-two patients with DM and twenty-nine patients with PM. Symptoms and laboratory data were compared between DM and PM and between those complicated with interstitial lung disease. Results No significant differences were found in the incidence of fatigue, muscle pain, swallowing difficulty, fever etc between the two groups. Lymphocytes in patients with DM [（1.135±0.48）×10^9/L] was significantly lower than that in PM [（1.78±0.90）×10^9/L, P=0.01]. Compared with PM, the numbers of CD3^＋ T cells [（612±332）count/μL vs （1543±945） count/μL, P=0.01], CD4^＋T cells [（370±175）count/μL vs （741±450） count/μL, P=0.02] as well as CD8^＋ T cells [（219±180） count/μL vs （738±644）count/μL, P=0.02）were all significantly decreased in the patients with DM. In addition, the level of serum albumin[（34.2±4.7）g/L vs （38.1±5.5）g/L, P=0.01] was significantly decreased in patients with DM. CD4^＋T/CD8^＋T ratio in DM patients was significantly higher than that in PM patients [（2.6±1.5） vs （1.5±1.0）, P=0.03]. The number of peripheral blood lymphocytes[（1.47±1.04）×10^9/L vs （1.70±0.85）×10^9/L, P=0.04] and the serum creatine kinase level[（1220.8±2118.5）U/L vs （3150.79±2965.87） U/L, P=0.02]in patients with DM-ILD were both significantly lower than those with PM-ILD patients. CD4^＋T/CD8^＋T ratio in PM-ILD patients was significantly higher than that in DM-ILD patients[（2.3±1.4） vs （1.4±0.4）, P=0.00]. Conclusion The clinical symptoms of DM are similar to thoses of PM. The significantly decreased total and subset counts of peripheral lymphocytes in DM indicates that immune imbalance may play an important role in the pathogenesis of DM.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2016年第12期1067-1069,共3页
Chinese Journal of Practical Internal Medicine
基金
国家自然科学基金(81271324)
关键词
皮肌炎
多发性肌炎
T淋巴细胞
间质性肺病
dermatomyositis
polymyositis
T lymphocyte
interstitial lung disease.
