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目的 探讨中老年多发性肌炎的临床特点。方法 分析 6例中老年多发性肌炎的临床资料 ,并结合文献分析其临床和病理特点 ,治疗进展及预后。结果 6例均有肌无力和肌萎缩 ,部分伴有运动及感觉神经损害及其它系统损害。全部病例肌酶均明显升高 ,肌电图以肌源性损害为主 ,病理有肌纤维的变性、坏死、横纹消失及淋巴细胞浸润。结论 中老年多发性肌炎是一组以肌无力及肌萎缩为主要表现的自身免疫性疾病 ,本病的诊断应结合临床资料、肌酶和肌电图检查 ,有条件应行肌肉活检进行确诊 ,并进行全面检查 ,寻找可能存在的恶性疾病。激素治疗应早期、全程、足量 ,减量应缓慢 ,总疗程 1～ 2年。激素无效可试用免疫抑制剂。中药对提高疗效有辅助作用。预后可能与发病年龄、治疗时机、及合并症有关。
Objective To investigate the clinical features of polymyositis in the elderly. Methods The clinical data of 6 cases of polymyositis in middle and old age were analyzed. The clinical and pathological features, treatment progress and prognosis were analyzed based on the literature. Results Six cases had myasthenia and muscle atrophy, some were accompanied by motor and sensory nerve damage and other systemic injuries. All cases of muscle enzymes were significantly increased, EMG to myogenic damage-based, pathological muscle fiber degeneration, necrosis, striated disappearance and lymphocyte infiltration. Conclusion Middle-aged and elderly polymyositis is a group of autoimmune diseases with myasthenia gravis and muscle atrophy as the main manifestations. The diagnosis of this disease should be combined with clinical data, muscle enzymes and EMG examination, the condition should be confirmed by muscle biopsy, And conduct a comprehensive inspection to find possible malignant diseases. Hormone therapy should be early, full, adequate, reduction should be slow, the total course of 1 to 2 years. Hormone invalid immunosuppressant trial. Chinese medicine to improve the efficacy of ancillary effects. Prognosis may be related to the age of onset, timing of treatment, and comorbidities.