肌炎/皮肌炎并发纵隔气肿临床分析

基础医学与临床 ›› 2010, Vol. 30 ›› Issue (1): 84-86.

肌炎/皮肌炎并发纵隔气肿临床分析

苏金梅陈华徐东侯勇孙锡芹张文唐福林

中国医学科学院北京协和医学院北京协和医院中国医学科学院北京协和医学院北京协和医院中国医学科学院北京协和医学院北京协和医院中国医学科学院北京协和医学院北京协和医院吉林市第二中心医院中国医学科学院北京协和医学院北京协和医院风湿免疫科中国医学科院北京协和医学院北京协和医院

收稿日期:2009-07-14 修回日期:2009-09-16 出版日期:2010-01-05 发布日期:2010-01-05
通讯作者: 唐福林

The clinical characteristics of pneumomediastinum in patients with dermatomyositis and polymyositis

Jin-mei SU, Hua CHEN, Dong XU, Yong HOU, Xi-qin SUN, Wen ZHANG, Fu-lin TANG

PUMC Hospital, CAMS & PUMC the Second Central Hospital of Jilin Department of Rheumatology，PUMC Hospital，CAMS&PUMC PUMC Hospital, CAMS & PUMC

Received:2009-07-14 Revised:2009-09-16 Online:2010-01-05 Published:2010-01-05
Contact: Fu-lin TANG

摘要/Abstract

摘要： 目的分析肌炎/皮肌炎（PM/DM）合并纵隔气肿的临床特点、治疗和转归，探求发病机制和影响预后的因素。方法回顾性分析5例PM/DM病人的临床资料。复习英文文献报道的24例PM/DM并发纵隔气肿的病例特点。结果 5例合并纵隔气肿，发生纵隔气肿前都有肺部感染。29例（含本文5例）合并纵隔气肿病例中10例应用甲基泼尼松龙冲击，4例存活，6例死亡。10例应用环孢素治疗，其中8例存活，2例死亡。结论 PM/DM患者合并纵隔气肿的发病机制中，感染也是一个重要因素。甲基强的松龙冲击治疗效果差，而环孢素治疗有效。

关键词: 多发性肌炎, 皮肌炎, 纵隔气肿

Abstract: Objective To analyze the clinical characteristics of pneumomediastinum in patients with dermatomyositis and polymyositis and to study its pathogenesis and prognosis. Methods The clinical records of 96 patients with PM/DM were reviewed, focusing mainly on the presence of pneumomediastinum. Five patients with pneumomediastinum are described in detail. Case reports of pneumomediastinum in PM/DM in English publications are reviewed. Results Five DM cases complicated by pneumomediastinum all had lung infections. 29 cases (including our five cases) of DM/PM with pneumomediastinum have taken methylprednisolone, four cases alive, and six died. Ten cases have taken CsA，eight cases alive and two died. Conclusions The infections was strongly suspected as being responsible for the pneumomediastinum. methylprednisolone has poor effect. CsA can be an effective therapeutic agent in PM/DM.

Key words: Polymyositis, Dermatomyositis, Pneumomediastinum

苏金梅陈华徐东侯勇孙锡芹张文唐福林. 肌炎/皮肌炎并发纵隔气肿临床分析[J]. 基础医学与临床, 2010, 30(1): 84-86.

Jin-mei SU; Hua CHEN; Dong XU; Yong HOU; Xi-qin SUN; Wen ZHANG; Fu-lin TANG. The clinical characteristics of pneumomediastinum in patients with dermatomyositis and polymyositis[J]. Basic & Clinical Medicine, 2010, 30(1): 84-86.