CAJ | 학술논문

目的探讨皮肌炎( dermatomyositis,DM)的肌肉病理特征、肌纤维间的微血管改变以及与多发性肌炎( polymyositis,PM)肌肉病理的差异.方法对16例DM和5例PM患者行肌肉活检,9例健康人骨外伤患者为对照组,做常规组织病理学检测和免疫组化染色(CD34、CD61).结果 37.5％DM患者有束周萎缩,肌纤维间微血管周围有较明显炎症细胞浸润的为18.8％,而PM及正常组的肌肉中未见束周萎缩.DM患者肌纤维间CD34标记的微血管数明显减少,而PM正常；16例DM中5例CD61呈阳性表达(束周区),5例为弱阳性,阳性率为62.5％；PM仅1例呈弱阳性；正常对照组为阴性.结论肌纤维间的微血管减少和新生血管形成也是DM肌肉病变的特征之一,该特征可用于DM与PM肌肉病理的鉴别.
목적 탐토피기염( dermatomyositis,DM)적기육병리특정、기섬유간적미혈관개변이급여다발성기염( polymyositis,PM)기육병리적차이.방법 대16례DM화5례PM환자행기육활검,9례건강인골외상환자위대조조,주상규조직병이학검측화면역조화염색(CD34、CD61).결과 37.5％DM환자유속주위축,기섬유간미혈관주위유교명현염증세포침윤적위18.8％,이PM급정상조적기육중미견속주위축.DM환자기섬유간CD34표기적미혈관수명현감소,이PM정상；16례DM중5례CD61정양성표체(속주구),5례위약양성,양성솔위62.5％；PM부1례정약양성；정상대조조위음성.결론 기섬유간적미혈관감소화신생혈관형성야시DM기육병변적특정지일,해특정가용우DM여PM기육병리적감별.
Objective To assess pathological features of muscles as well as microvascular changes between muscle fibers in patients with dermatomyositis (DM),and to analyze pathological differences in muscles between DM and polymyositis (PM).Methods Specimens were obtained from involved muscles of 16 patients with DM,5 patients with PM,and from normal muscles of 9 patients with bone trauma (controls).Routine histopathological examination and immunohistochemical staining for CD34 and CD61 were conducted.Results Of the 16 patients with DM,6 (37.5％) had perifascicular atrophy,3 ( 18.8 ％) had an obvious inflammatory cell infiltration around microvessels between muscle fibers.Perifascicular atrophy was absent in muscle specimens from patients with PM or bone trauma.The number of CD34-positive microvessels between muscle fibers was reduced in patients with DM,but normal in those with PM.CD61 was positive in perifascicular area of 10 patients (5 moderately positive and 5 weakly positive) with DM,with an expression rate of 62.5％,however,only 1 case of PM was weakly positive for CD61,and all the controls were negative.Conclusions There is a decrease in the number of microvessels but an enhancement of neovascularization between muscle fibers in involved muscles of patients with DM,which may serve as a pathological marker to distinguish DM from PM.