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报告1例伴心肌特异性肌钙蛋白T(c Tn T)升高的皮肌炎。患者女,38岁。发热、肌肉无力2个月,躯干及四肢红斑1个月。实验室及辅助检查:肌酸激酶(CK)、肌酸激酶同工酶MB(CK-MB)及c Tn T明显升高,反复心电图、心脏彩超检查未见异常,除外心肌损伤。诊断:皮肌炎。予糖皮质激素联合甲氨蝶呤治疗3个月,皮损消退,肌无力、肌痛症状缓解,c Tn T随CK、CKMB下降而下降。对国内外文献复习,皮肌炎患者可以有c Tn T升高。因此,对于c Tn T升高的结果判断还需要结合临床表现及其他检查综合分析,避免误诊。
One case of dermatomyositis with elevated cardiac troponin T (cTn T) was reported. Female patient, 38 years old. Fever, muscle weakness 2 months, trunk and limbs erythema 1 month. Laboratory and auxiliary examination: creatine kinase (CK), creatine kinase MB (CK-MB) and cTn T were significantly increased, repeated ECG, echocardiography showed no abnormalities, except for myocardial injury. Diagnosis: Dermatomyositis. Glucocorticoid combined with methotrexate for 3 months, skin lesions subsided, muscle weakness, relieve myalgia, cTn T decreased with CK, CKMB decreased. Review of the literature at home and abroad, patients with dermatomyositis can have elevated c Tn T. Therefore, the judgment of the result of elevated cTn T needs to be combined with clinical manifestations and other examinations comprehensive analysis to avoid misdiagnosis.