172例晚发型重症肌无力患者的临床特点及疗效分析
目的分析晚发型重症肌无力(MG)患者的临床特点及其对不同治疗方案治疗效果的影响。方法搜集172例晚发型MG患者(发病年龄≥50岁)的临床资料,包括性别构成、首发症状、临床分型及胸腺病理类型。采取4种不同的治疗方案:胆碱酯酶抑制剂,胆碱酯酶抑制剂+激素,胆碱酯酶抑制剂+免疫抑制剂和常规治疗+胸腺切除术。治疗后6~24个月后进行疗效评估。结果在172例晚发型MG患者中,男95例,女77例,男∶女=1∶0.81,临床分型以ⅡB型(49.4%)为主,首发症状以眼外肌受累为主(87.8%),胸腺病理类型中胸腺瘤和胸腺增生者分别占44.6%和52.7%(P〉0.05)。统计学分析提示,晚发型MG患者的预后...
Saved in:
Published in | 解放军医学杂志 Vol. 36; no. 8; pp. 839 - 842 |
---|---|
Main Author | |
Format | Journal Article |
Language | Chinese |
Published |
2011
|
Subjects | |
Online Access | Get full text |
Cover
Loading…
Summary: | 目的分析晚发型重症肌无力(MG)患者的临床特点及其对不同治疗方案治疗效果的影响。方法搜集172例晚发型MG患者(发病年龄≥50岁)的临床资料,包括性别构成、首发症状、临床分型及胸腺病理类型。采取4种不同的治疗方案:胆碱酯酶抑制剂,胆碱酯酶抑制剂+激素,胆碱酯酶抑制剂+免疫抑制剂和常规治疗+胸腺切除术。治疗后6~24个月后进行疗效评估。结果在172例晚发型MG患者中,男95例,女77例,男∶女=1∶0.81,临床分型以ⅡB型(49.4%)为主,首发症状以眼外肌受累为主(87.8%),胸腺病理类型中胸腺瘤和胸腺增生者分别占44.6%和52.7%(P〉0.05)。统计学分析提示,晚发型MG患者的预后与临床分型及治疗方案无关,但与发病年龄明显相关。发病年龄50~59岁的晚发型MG患者的治疗有效率(94.9%)最高,60~69岁患者的治疗效果有效率最差(69.7%,P=0.0044)。结论大部分晚发型MG患者的病情较重,患者中合并胸腺增生和胸腺瘤的比例相当,疗效与发病年龄有关。 |
---|---|
Bibliography: | myasthenia gravis; late-onset; clinical protocols; treatment outcome 11-1056/R Objective To analyze the clinical characteristics of late-onset myasthenia gravis(MG),and explore the therapeutic effects of different therapeutic regimens for MG.Methods The clinical data of 172 patients(95 males and 77 females) with late-onset(age of onset≥50) MG were analyzed,including sex ratio,initial symptoms,clinical classification and type of pathology of the thymus.Four therapeutic regimens were carried out in patients respectively,comprising acetylcholinesterase inhibitor alone,acetylcholinesterase inhibitor plus corticosteroid,acetylcholinesterase inhibitor plus immunosuppressive agents,and conventional therapy plus thymectomy.The therapeutic effects of each regimen were evaluated 6-24 months after treatment.Results Of the 172 patients with late-onset MG,85(49.4%) were classified as clinical type of IIB,with the main initial symptom mainly involving extraocular muscles(87.8%),and thymoma(44.6%) and hyperplastic thymus(52.7 |
ISSN: | 0577-7402 |