Bradna P, Pospísil M, Vizd'a J, Duska F
II. interní klinika fakultní nemocnice, Hradec Králové.
Vnitr Lek. 1990 Nov;36(11):1066-71.
Improvement of the diagnosis and new therapeutic opportunities revealed a number of organ affections also in patients with polymyositis and dermatomyositis. One of the prognostically important organ manifestations is affection of the heart. The prospective investigation comprises 15 patients with a confirmed diagnosis of polymyositis (10) or dermatomyositis (5). The investigation, using a number of non-invasive method (ECG, echocardiography, systolic time intervals, 99mTc pyrophosphate scan of the heart muscle), proved in the course of the 60-month investigation an increase of pathological findings from 40% at the onset (6/15) to 6 from 11 surviving patients (three died), i.e. a total of 64.3% of the group. Investigation of the fate of patients with signs of myocardial damage during the active stage of the disease (positive myocardial scan) indicates that in these patients also other signs of cardiac damage develop more frequently and that the general prognosis is more unfavourable. The authors consider therefore cardiac damage in the active stage of the disease a reason for intensive treatment.
诊断方法的改进和新治疗手段的出现表明，多发性肌炎和皮肌炎患者还存在多种器官病变。其中，心脏病变是对预后有重要影响的器官表现之一。这项前瞻性研究纳入了15例确诊为多发性肌炎（10例）或皮肌炎（5例）的患者。研究采用了多种非侵入性方法（心电图、超声心动图、收缩期时间间期、心肌99mTc焦磷酸盐扫描），在为期60个月的研究过程中发现，病理检查结果从发病时的40%（6/15）增加到11例存活患者中的6例（3例死亡），即该组患者中共有64.3%出现病理改变。对疾病活动期有心肌损伤迹象（心肌扫描阳性）的患者的转归调查表明，在这些患者中，其他心脏损伤迹象也更频繁地出现，总体预后更差。因此，作者认为疾病活动期的心脏损伤是强化治疗的一个原因。
