MRPMedical Research and Practice2993-96902993-9704Art and Design10.61369/MRP.12712Article流感病毒感染并发儿童良性急性肌炎临床特征和对比研究https://artdesignp.com/journal/MRP/3/2/10.61369/MRP.12712王杨,刘力2025322025-02-20目的：本研究回顾性总结流感病毒感染并发儿童良性急性肌炎（Benign acute childhood myositis，BACM） 患儿共50例的临床特征、临床转归、随访情况并进行统计学分析。并将BACM与儿童特发性炎性肌病（IdiopathicInflammatory Myopathies，IIM）的临床特征、实验室结果进行对比研究，为这两种疾病的临床诊断和鉴别诊断提供思路。方法：本研究纳入本院2023年3月至2023年5月于天津市儿童医院住院诊治的BACM的患儿50例，及2020年1月至2023年12月于天津市儿童医院住院诊治的IIM患儿11例。回顾性收集研究对象临床资料、实验室检查结果、治疗方案、病情转归和随访情况，分析BACM组患者临床特征及两组患者之间的差异。结果：BACM 50例患儿中男41例(82.0%)，女9例(18.0%)，年龄5.03 ～ 8.02 岁，病原学检查甲型流感病毒核酸检测阳性者45例(90.0%)，乙型流感病毒核酸检测阳性者5例(10.0%)。双侧小腿疼痛48例(94.0%)，1例为双膝关节区疼痛，1例为仅右侧小腿疼痛。27例出现步态异常(54.0%)，20例下肢肌力5级，24例下肢肌力4级，6例不能配合肌力检查。IIM组中11例患者（100.0%）均有活动受限及肌力下降，7例（63.6%）患者同时有双上肢、双下肢受累，特发性炎性肌病组疼痛部位不局限于双下肢，可以累及肩胛带肌、腰大肌、上肢肌肉群，而且CK、CKMB、Mb、AST、ALT、LDH均高于BACM组。结论：BACM与当地流感病毒大流行密切相关，具有自限性，疾病预后良好，恢复快。IIM治疗较为困难，出现症状到确诊时间更长，而且CK、CKMB、Mb、AST升高程度明显高于BACM组。在初始治疗后4周CK 不能恢复正常。对比研究发现，CK 和CKMB升高幅度越低则诊断BACM可能性越大。儿童良性急性肌炎,流感病毒,特发性炎性肌病,临床特征,诊断

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