Tymms K E, Webb J
J Rheumatol. 1985 Dec;12(6):1140-8.
Of 105 cases seen over 12 years with mean 4 years followup, there were 69 with polymyositis (PM) and 36 with dermatomyositis (DM). and in 43 this complicated another connective tissue disease (CTD). Primary PM had onset a decade later than others and most severe myopathy occurred in DM. Earliest symptoms were polyarthritis and Raynaud's phenomenon with frequent sicca syndrome (51%). The less than universal prevalence of elevated muscle enzymes (68%), myopathic electromyography (86%). and abnormal muscle biopsy (78%) emphasizes the need for complete evaluation in all cases. Improvement occurred in 69% overall, including all 23 given no therapy or low dose corticosteroids and 59% of the remainder who received high dose corticosteroids with added cytotoxics in one-quarter. Outcome was worse in older patients and in those where weakness exceeded 4 months before diagnosis. Eight of 19 deaths were due to myositis or its therapy which also caused considerable morbidity. Malignancy in 16 cases was temporally related to myositis in half of these cases.
在12年间观察到的105例患者中，平均随访4年，其中69例为多发性肌炎（PM），36例为皮肌炎（DM）。43例合并另一种结缔组织病（CTD）。原发性PM的发病时间比其他类型晚十年，最严重的肌病发生在DM中。最早的症状是多关节炎和雷诺现象，常伴有干燥综合征（51%）。肌酶升高（68%）、肌病性肌电图（86%）和肌肉活检异常（78%）并非普遍存在，这强调了对所有病例进行全面评估的必要性。总体改善率为69%，包括所有未接受治疗或接受低剂量皮质类固醇治疗的23例患者，以及其余接受高剂量皮质类固醇治疗并在四分之一患者中加用细胞毒性药物的患者中的59%。老年患者以及诊断前肌无力超过4个月的患者预后较差。19例死亡中有8例是由于肌炎或其治疗，这也导致了相当高的发病率。16例恶性肿瘤中有一半在时间上与肌炎相关。
