皮肌炎或多发性肌炎(dermatomyositis or polymyositis,DM/PM)是一种主要以骨骼肌非化脓性炎症为特征的自身免疫性炎性肌病,和多种恶性肿瘤的发生有关.为提高对DM/PM并发恶性肿瘤的认识,我们对近三年多来在我院住院的121例DM/PM患者临床资料进行分析总结,现报告如下.

目的 探讨多发性肌炎/皮肌炎合并急性间质性肺炎的血清肌酶的特点,提高诊断治疗水平.方法 对江苏省人民医院及丹阳市人民医院2000年1月至2007年8月收治的13例多发性肌炎/皮肌炎合并急性间质性肺炎患者的临床资料进行回顾性分析.结果 10例皮肌炎患者均有典型皮肌炎皮疹,其中9例肌炎症状轻微,所有病例抗JO-1抗体阴性,乳酸脱氢酶(LDH)7例持续升高,6例轻度升高,13例患者肌酸磷酸激酶(CK)7例升高,3例多肌炎升高明显,天冬氨酸转氨酸(AST)9例皮肌炎升高,5例CK/AST水平下降,3例多肌炎均升高.在确诊多发性肌炎/皮肌炎同时或短期内并发出现高热、干咳、呼吸困难,X线片和胸部CT提示多发的片状肺间质改变,并且进展迅速,抗感染和大剂量甲基泼尼松龙治疗无效,10例死亡.结论 急性间质性肺炎可能是无肌病皮肌炎或肌病轻微的皮肌炎的肺部表现,CK水平与预后无明显相关性,LDH持续升高提示预后不良,AST水平与肺间质改变相关.

原发性干燥综合征(pSS)是以外分泌腺淋巴细胞浸润为特征的自身免疫性疾病,唾液腺和泪腺受累所致口干、眼干是本病的基本表现,但常被患者或医师忽略.以外分泌腺体外的器官损害为首发表现者早期诊断困难,以致本病误诊发生率较高.本文回顾分析了93例诊断pSS患者的临床表现及特点,提高早期诊断水平,减少误诊率.

Objective:To evaluate the efficacy and toxicity of gemcitabine combined with cisplatin and dexamethasone in the treatment of patients with relapsed or refractory non-Hodgkin's lymphoma.Methods:Thirteen patients with histologically confirmed relapsed or refractory non-Hodgkin's lymphoma were enrolled in this study.The chemotherapy regimen consisted gemcitabine(1g/m2,days 1 and 8),cisplatin(25mg/m2,day 1-3) and dexamethasone(20mg/d,day 1-5) given every three weeks,every patients received at least for 2 cycles.Results:Of 13 patients,9 patients(69.2%) showed response including 4 patients(30.8%) having complete response and 5 patients(38.5%) partial response.The median time to progression of disease for twelve patients that were received the follow-up was 7.9 months(95%CI:7.4-9.4 months).Drug related toxic effects were mild gastrointestinal reactions in most patients as well as mild bone marrow depression in some patients such as neutropenia,thrombocytopenia.Conclusion:The combination of gemcitabine,cisplatin and dexamethasone possesses better short-term efficacy,acceptable toxicity,and obvious alleviation of symptoms related to the disease.This protocol is worthy to be warranted as salvage for relapsed or refractory non-Hodgkin's lymphoma.