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目的 :为了避免临床误诊 ,对结核病的肌肉病变特点进行探讨。方法 :复习 2 5例经尸检证实为急 /亚急性血播散性结核的病例 ,其中 3例临床上主要表现为皮肤和肌肉损害 ,分别在患者生前诊断为皮肌炎 (2例 )和多发性硬化症 (1例 )。对其骨骼肌进行详细的镜下观察。结果 :四肢肌、膈肌、食道和喉的横纹肌均有程度不同的变性、坏死和淋巴细胞浸润 ,表现为 :(1)肥大或萎缩 ;(2 )嗜酸性、玻璃样和絮状变性 ;(3)溶解和凝固性坏死 ;(4 )巨噬细胞增生 ;(5 )淋巴细胞灶状浸润。食管、胃、肠和膀胱平滑肌有收缩带样坏死。结论 :骨骼肌损伤可能和结核性自身免疫反应有关。收缩带样坏死无疾病特异性 ,可能是肌组织频死状态的一种形态学表现
Objective: In order to avoid clinical misdiagnosis, the characteristics of muscle lesions of tuberculosis were explored. Methods: Twenty-five cases of acute / subacute blood smear-confirmed tuberculosis confirmed by autopsy were reviewed. Of the 3 cases, the main clinical manifestations were skin and muscle damage, which were diagnosed as dermatomyositis (2 cases) and multiple Sexual sclerosis (1 case). Skeletal muscle for a detailed microscopic observation. RESULTS: The limbs muscles, diaphragms, esophagus and laryngeal striated muscle had varying degrees of degeneration, necrosis and lymphocytic infiltrates, manifested as: (1) hypertrophy or atrophy; (2) eosinophilic, vitreous and flocculent degeneration; ) Dissolved and coagulation necrosis; (4) macrophage hyperplasia; (5) lymphocyte foci infiltration. Esophageal, stomach, intestine and bladder smooth muscle with contracted band-like necrosis. Conclusion: Skeletal muscle injury may be related to tuberculosis autoimmune reaction. Shrinkage-like necrosis No disease-specific, may be a morphological manifestation of the frequency of muscle tissue death