Mimura Yoshihiro, Ihn Hironobu, Jinnin Masatoshi, Asano Yoshihide, Yamane Kenichi, Tamaki Kunihiko
Department of Dermatology, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, 113 Bunkyo-ku, Tokyo, Japan.
Clin Rheumatol. 2005 Apr;24(2):99-102. doi: 10.1007/s10067-004-0975-7. Epub 2004 Aug 20.
Skeletal muscle involvement, or myopathy, has been a recognized feature of systemic sclerosis (SSc). We studied retrospectively 302 Japanese patients with SSc to elucidate the clinical and laboratory features in scleroderma patients developing skeletal myopathy during their clinical course. Forty-three patients (14%) developed skeletal myopathy during their course of the disease. The mean age of the patients who developed skeletal myopathy was significantly lower than that of those who did not. The ratio of male to female was significantly higher in the myopathic patients. The patients with diffuse cutaneous SSc were more likely to develop myopathy than those with limited cutaneous SSc. The prevalences of heart involvement, pulmonary fibrosis, diffuse pigmentation of the skin, and contracture of phalanges were significantly greater in those with skeletal myopathy than in those without. None of the patients with skeletal myopathy had anticentromere antibody. These findings suggested that the SSc patients with severe internal organ involvement, such as pulmonary fibrosis and heart disease, and some other complications were prone to develop skeletal myopathy during their clinical course of the disease.
骨骼肌受累,即肌病,一直是系统性硬化症(SSc)的一个公认特征。我们对302例日本SSc患者进行了回顾性研究,以阐明在临床过程中发生骨骼肌肌病的硬皮病患者的临床和实验室特征。43例患者(14%)在病程中发生了骨骼肌肌病。发生骨骼肌肌病的患者的平均年龄显著低于未发生者。肌病患者中男性与女性的比例显著更高。弥漫性皮肤型SSc患者比局限性皮肤型SSc患者更易发生肌病。骨骼肌肌病患者中心脏受累、肺纤维化、皮肤弥漫性色素沉着和指骨挛缩的患病率显著高于无肌病患者。骨骼肌肌病患者均无抗着丝点抗体。这些发现提示,伴有严重内脏受累(如肺纤维化和心脏病)及其他一些并发症的SSc患者在疾病临床过程中易于发生骨骼肌肌病。