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目的探讨多发性肌炎(PM)、间质性肌炎(IM)与神经肌炎(NM)的临床特点及神经肌肉活检的诊断价值。方法回顾分析247例炎症性肌病的临床表现及神经肌肉活检结果。结果3组临床表现相似,为近端肌无力、肌痛等;均有不同程度的肌酶增高,但PM组增高明显;IM和NM具有PM的病理改变,但炎性程度不及PM,又各有其特异性,IM组为炎性细胞浸润间质,NM组神经活检多有髓鞘脱失、炎性细胞浸润。结论PM、IM、NM炎性肌病的临床表现相似,诊断困难,需结合神经肌肉活检等辅助检查才能作出正确的诊断。
Objective To investigate the clinical features of polymyositis (PM), interstitial myositis (IM) and neuromyositis (NM) and the diagnostic value of neuromuscular biopsy. Methods Retrospective analysis of 247 cases of inflammatory myopathy clinical manifestations and neuromuscular biopsy results. Results The clinical manifestations of the three groups were similar, with proximal muscular weakness and myalgia. All of them had different degrees of muscle enzymes increased, but PM group increased significantly. IM and NM had pathological changes of PM, but the degree of inflammation was less than that of PM, Its specificity, IM group of inflammatory cell infiltration of interstitial, NM group of nerve biopsy demyelination, inflammatory cell infiltration. Conclusions The clinical manifestations of PM, IM and NM inflammatory myopathy are similar and the diagnosis is difficult. Correct diagnosis should be done with the help of neuromuscular biopsy and other auxiliary examinations.