摘要
目的:探讨儿童皮肌炎(JDM)的临床特点。方法:回顾分析21例JDM患儿的临床资料,总结其临床表现及实验室检查特点。结果:首发症状中单纯皮疹占33.3%,单纯四肢近端肌无力、肌痛23.8%,皮疹伴四肢近端肌无力9.5%。皮肤损害以上眼睑紫红斑或向阳性紫红斑最多61.8%,后期钙质沉着9.5%。内脏损害中心脏、肺、胃肠道受累分别为57.1%、52.4%、28.6%,无1例伴发恶性肿瘤。血清肌酶检查乳酸脱氢酶(LDH)、羟丁酸脱氢酶(HBDH)、天冬氨酸转氨酶(A ST)、肌酸激酶(CK)升高,分别为100%、100%、90.5%、57.1%,抗Jo-1抗体阳性率为5.3%。肌电图显示75%的患儿存在肌源性损害,2例行肌活组织检查均为阳性。结论:JDM多以皮肤损害为首发症状,后期可引起钙质沉着;内脏损害中以心脏和肺损害多见。实验室检查中肌酶升高频率LDH=HBDH>A ST>CK;抗Jo-1抗体临床诊断价值不大。
Objective：To investigate the clinical characteristics of juvenile dermatomyositis. Methods ：Clinical data of 21 cases of JDM were studied retrospectively to summarize the characteristics of clinical manifestation and laboratory examination. Results ：In the first manifestations of the disease ,rash was present in 33.3% of the patients ,dermatitis in 23.8% ,rash and dermatit is simultaneously in 9.5%. Erythema in palpebra frontalis was present in 61.8% in skin lesion. Calcinosis late in the course of the disease was present in 9.5%. Heart involved in JDM were 57. 1%, lungs 52.4% and gastrointestinal tract were 28.6%. No one was complicated with malignancy. In the creatase data, the positive rate of lactate dehydrogenase （LDH）was 100 % , hydroxybutyrate dehydrogenase （HBDH） 100 %, aspartate transaminase （AST） 90.5 % ,creatine kinase 57. 1 % respectively. The positive rate of anti-jo-1 antibody was 5.3 %.Electromyogram revealed myogenic damage 75 %. Two children was taken muscle biopsy which result all were abnormal. Conclusion ：The first symptome of JDM is skin lesion at most ,which can result in calcinosis late in the course of the disease. The cardiac and pulmonary involvement are often seen in the children of internal ograns abnormality. The frequency of elevation of serum levels of the creatase is LDH=HBDH〉AST〉CK. Anti Jo-1 antibody lack diagnostic value.
出处
《临床医药实践》
2007年第2期100-102,共3页
Proceeding of Clinical Medicine
关键词
儿童
皮肌炎
临床分析
children
juvenile dermatomyositis
clinical andysis
