| Objective : To investigate the influence factors of treatment that refractory to corticosteroids in polymyositis.Methods:93 in-patients with polymyositis were investigated from Jun 2002 to November 2009 in First Affiliated Hospital of Fujian Medical University. Following Gu's definition in 2005:When treated with corticosteroids dose>1 ~ 2mg/kg.d for one month,the symtoms still can not be improved or creatine kinase is still abnormal, it is called steroids-resistance, whereas the steroids-sensitivity.Patients without adequate treatment, or without reviews of CK one month later were exclued.Dived them into two groups,20 patients with steroids-senstive and 39 with steroids-restistent,33 patients were exclued.Clinical and laboratory data were collected ,including Sex, age, throat muscle involvement, muscle weight, heart involved, hepatosplenomegaly and lymphadenopathy, associated with cancer, associated with connective tissue disease, elevated serum creatine kinase .The data was analyzed by SPSS software,respectively by mono-factor analysis and Logistic regression test. The data of chest radiographic findings, autoantibody spectrum, immune serum globulin, thyroid function, EMG, were also collected.Results: mono-factor analysis:CK,p=0.000;musle strength, OR=3.88,p=0.022; There were no differences in sex, age, throat muscle involvement, heart involved, hepatosplenomegaly and lymphadenopathy,associated with cancer and connective tissue disease by statistics. Logistic regression test:Elevated CK is an independent risk factor.In addition, Four patients with Myotonia in EMG all refractory to corticosteroids.Conclusions:1.CK evaluate is one independent risk factor of refractory to corticosteroids with polymyositis,should be confirmed.2. Sex, age, throat muscle involvement, heart involved, associated with cancer, associated with connective tissue disease cannot be defined as a risk factor in this study.3. Myotonia in EMG may be a risk factor of refracting to corticosteroids.
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