多發性肌炎與皮肌炎之臨床表徵與預後因素

Clinical Features and Prognostic Factors in Polymyositis/ Dermatomyositis

我們將所有在民國六十四年至七十六年間因多發性肌炎或皮肌炎注入三軍總醫院的病患做一番整理回顧。在十八位病患中，診斷確立者佔十七位，極可能者一位；而其中皮肌炎佔八位。病程中最常見的主訴及臨床物理檢查發現依序為：肌肉無力（佔17位），肌肉壓痛（11位），發燒（7位），吞嚥困難（6位），關節炎或關節痛（5位），雷諾氏症候群（1位），發音困難（1位）。所有病患之肌電圖檢查皆異常，其中82％肌肉切片病理檢查符合多發性肌炎或皮肌炎之診斷。又四位病患併發有惡性腫瘤。所有病患有七位死亡，最常見死因為惡性腫瘤或肺臟併發症。顯示預後不佳的徵候包括年老，肺臟受侵犯及伴生有關節炎或關節痛。

An effort was made to identify all patients with polymyositis/ dcrmatomyositis (PM/ DM) admitted to Tri-Service General Hospital (TSGH) from 1975~1987. The diagnosis of PM/ DM was retrospectively reviewed in 18 (17 definite, 1 probable) cases, DM accoountcd for 8 patients. The most common complaints and physical findings in the course of the disease was muscle weakness (17 patients), muscle tenderness (11 patients), fever (7 patients), dysphagia (6 patients), arthritis or arthralgia (5 patients), Raynaud's phenomenon (1 patient), and dysphonia (1 patient). 100% had abnormal electromyogram results, and 82% had muscle histopathology consistent with PM/ DM. Malignancy was diagnosed in 4 patients. The most common causcs of death (7 cases) were malignancy and pulnionary complications. Independent unfavorable prognostic signs were: older age, pulmonary involvement and arthritis or arthralgia.