皮肌炎与多发性肌炎临床表现和实验室检查对比分析

发布时间：2019-05-28 13:41

【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。
[Abstract]:Objective To compare the clinical and laboratory findings of dermatomyositis (DM) and polymyositis (PM). Methods The clinical data of 62 cases of DM and 29 cases of PM from January 1,2012 to October 31,2015 were analyzed retrospectively. The similarities and differences in laboratory tests for DM and PM patients with interstitial lung disease (ILD) were compared. Results The frequency of occurrence of fatigue, myalgia, dysphagia, fever and other symptoms was not statistically significant between the DM and PM groups. The numbers of peripheral blood lymphocytes in DM group were (1.13-0.48) and 10-9/ L, significantly less than that of PM group (1.78-0.90) and 10-9/ L (P = 0.01). The number of CD3 ~ + T cells in DM patients[(612-332)/. mu.L (1543-945)/. mu.L, P = 0.01], number of CD4 ~ + T cells[(370-175)/. mu.L (741-450)/. mu.L, The number of CD8 + T cells[(219-178)/. mu.L (738-644)/. mu.L, P = 0.02] was significantly less than that of the PM group. The ratio of CD4 + T/ CD8 + T in PM patients was (2.6% 1.5), which was significantly higher than that of DM patients (1.5% 1.0) (P = 0.03). The serum albumin level in DM patients[(34.2[4.7) g/ L (38.1[5.5) g/ L, P = 0.01] was significantly reduced compared with PM patients. The peripheral blood lymphocyte count of DM (DM-ILD) patients with ILD[(1.47-1.04),10-9/ L (1.70-0.85)[10-9/ L, P = 0.04], the level of serum creatine kinase was significantly lower than that of PM patients with ILD (PM-ILD)[(1220.8-2118.5) U/ L (3150.8-2965.9) U/ L, P = 0.02]. The ratio of CD4 + T/ CD8 + T in DM-ILD was 2.3-1.4, 1.4% 0.4 (P = 0.00) significantly higher in patients with PM-ILD. Conclusion DM and PM have similar points in clinical symptoms, but there are significant differences in the total number of T cells in peripheral blood and the number of different subpopulations, suggesting that the immune imbalance plays an important role in the pathogenesis of DM patients.
【作者单位】：中国医科大学附属第一医院风湿免疫科;
【基金】：国家自然科学基金(81271324)
【分类号】：R593.2

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