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目的分析皮肌炎合并急性间质性肺炎的临床特点,探讨发病原因,提高治疗水平。方法对我院1997—2005年收治的7例皮肌炎合并急性间质性肺炎患者进行回顾性分析,并复习相关文献。结果7例患者都有典型皮肌炎皮疹,但肌炎症状轻微。在确诊皮肌炎的同时或短期内合并出现高热、气急、干咳,胸片和胸部CT提示多发的片状肺间质改变,并且迅速进展。抗感染和大剂量甲泼尼龙治疗无效,7例患者全部死亡。结论急性间质性肺炎可能是无肌病皮肌炎或肌病轻微皮肌炎的肺部表现。为改善本组患者的预后,应尽早诊断,加强学科合作,制定更为合理有效的治疗方案。
Objective To analyze the clinical features of dermatomyositis complicated with acute interstitial pneumonia, to explore the causes and to improve the treatment level. Methods A retrospective analysis was performed on 7 cases of dermatomyositis with acute interstitial pneumonia admitted from 1997 to 2005 in our hospital. The related literatures were reviewed. Results All 7 patients had a typical dermatomyositis, but myositis had mild symptoms. In the diagnosis of dermatomyositis at the same time or shortly combined with fever, shortness of breath, dry cough, chest X-ray and chest CT prompted multiple flaky interstitial lung changes and rapid progress. Anti-infective and high-dose methylprednisolone treatment failed, all seven patients died. Conclusions Acute interstitial pneumonia may be a lung manifestation of myopathy-less myopathy or myopathy of minimal dermatomyositis. In order to improve the prognosis of this group of patients, we should make early diagnosis and strengthen cooperation in disciplines to formulate a more reasonable and effective treatment plan.