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皮肌炎 多发性肌炎与恶性肿瘤 |
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唐福林 赵绵松 张秀花
摘 要：目的 了解皮肌炎(dermatomyositis,DM)及多发性肌炎(polymyositis,PM)患者的恶性肿瘤发生情况。方法 收集1989—1998年北京协和医院收治的资料完整的DM/PM患者143例，全部符合1975年Bohan和Peter提出的DM/PM诊断标准，对其中18例合并肿瘤的患者与非肿瘤患者进行临床分析，肿瘤诊断及分型标准根据我国卫生部制定的肿瘤诊断分级标准而定。两组资料采用t及χ2检验。结果 143例患者男性46，女性97例。发病年龄4～76岁，平均年龄(42±38)岁，其中PM50例，男14例，女36例，DM93例，男24例，女69例。PM的肿瘤发生率为8%，DM的肿瘤发生率为15.6%。肿瘤分型：卵巢癌3例，鼻咽癌3例，恶组2例，乳癌2例，宫颈癌、子宫内膜卵巢样癌、肺癌、胃癌、前列腺癌、直肠癌、多发性骨髓瘤、淋巴瘤各1例。肿瘤先行发生者3例(16.6%)，后续发生者5例(27.8%)，同时发生者10例(55.6%)。本组病例中10例死亡，从PM/DM诊断到死亡的时间为1～84个月［中位数为(18±27)个月］，死亡原因包括肿瘤扩散，肿瘤相关的多脏器功能衰竭及感染。发病年龄、肺部和心脏受累，吞咽困难等指标在两组间显示有统计学意义。其中1例在肿瘤切除1年后，PM症状消失，另1例在肿瘤切除后1.5年DM症状缓解。结论 DM/PM与恶性肿瘤的发生率有高度相关性。
关键词：皮肌炎； 多发性肌炎； 肿瘤
Malignancy in patients with dermatomyositis/polymyositis
TANG Fulin ZHAO Miansong ZHANG Xiuhua
（Department of Rheumatology and Immunology,Peking Union Medical College Hospital,Beijing 100730,China）
Abstract：Objective To observe the association between dermatomyositis/polymyositis (DM/PM).Methods All 143 patients with DM/PM,admitted to Beijing Union Medical College Hospital during the 10 years (1988—1998),were studied for finding out prevalence and features of malignant disease among them. Patients with DM/PM alone,and with DM/PM and malignancy were analyzed clinically.The diagnosis and typing of malignancy in accordance with the China Health Ministry Organized Standard.Statistical analyses were done with χ2 or t test.Results Of the 143 patients with DM/PM (46 men and 97women), the onset age was 4～76 years (42±38 years).There were 14men and 36 women in 50 PM and 24 men and 69 women in 93 DM patients.malignancy occurred in 4 patients with PM (8%) and 14 with DM (15.6%).More frequency in the DM/PM population was than in the general population. In 10 patients,the malignancy and the DM/PM were diagnosed simultaneously (55.6%),in 3 patients before (16.7%) and in 5 patients after(27.8%).Ovarian,nasopharyngeal,lung and gastric carcino[1] [2] [3] 下一页
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