目的:探讨皮肌炎患者的药物治疗及康复训练相结合的方式对患者功能障碍恢复的效果评价。

方法:回顾性分析1例成年抗 MDA5 抗体阳性皮肌炎患者的临床资料、诊疗过程以及病情变化并结合相关文献进行分析。

结果:抗 MDA5 抗体阳性皮肌炎作为皮肌炎中的一个亚型,临床症状多变,重症患者进展迅速,应积极的予以免疫抑制联合疗法。本例患者采用多种免疫抑制疗法联合康复训练,疗效良好。体质量入院时为 37.5 kg,出院时为 42.5kg；洼田饮水试验入院时为4级,出院时恢复到1级,可正常饮食；Barthel 指数入院时 60 分,出院时恢复到 80 分,可独立上下楼梯。

结论:皮肌炎是一种多系统累及的隐匿性慢性疾病,大多数患者肌肉功能恢复欠佳,建立个体化的早期康复计划有利于患者的功能恢复。

Objective: To evaluate the effect of combination of medical treatment and rehabilitation training on the recovery of patients with dermatomyositis.

Methods: A retrospective review of the clinical data, the course of diagnosis and treatment and the changes in the clinical status of 1 adult patient with anti MDA5 antibody positive dermatomyositis was conducted in coniunction with the relevant literature.

Results: Anti MDA5 antibody positive dermatomyositis as a subtype of dermatomyositis with variable clinical presentation and rapid progression. It should be aggressively treated with combined immunosuppressive therapy. The  patient in this case received multiple immunosuppressive therapies combined with rehabilitation training,and the therapeutic effect was good. Her weight was 37.5 kg at admission and 42.5 kg at discharge. Kubota water swallow test showed admission grade 4,recovery to grade 1 on discharge, and normal diet, Barthel index was 60 at admission and  returned to 80 at discharge, and independent of stairs.

Conclusion:Dermatomyositis is an occult chronic disease with multiple systemic involvement and poor muscle function in most patients. Establishment of an individualized early rehabilitation program facilitates functional recovery.