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重症肌无力胸腺增生患者胸腺切除术的预后分析

已有 109 次阅读2021-3-29 16:19 |个人分类:TET学习|系统分类:医学科学

重症肌无力胸腺增生患者胸腺切除术的预后分析。Prognosis of thymectomy in myasthenia gravis patients with thymus hyperplasia
目的:比较不同情况下重症肌无力(MG)胸腺增生患者胸腺切除术后的预后。
材料与方法:收集2003-2013年间123例胸腺增生型重症肌无力患者的病历资料,进行随访研究。根据性别、发病年龄、病程及美国重症肌无力协会(MGFA)临床分型分为不同组,分析不同组的预后。
结果:123例患者中71例(59.5%)获得完全稳定缓解。在CSR上无显著性别差异。早发型(≤40岁)和病程小于12个月的MG患者的CSR率分别显著高于晚发型(>40岁)和病程大于12个月的MG患者,而MGFA临床I型和MGFA II型患者的缓解率无差异。
结论:胸腺增生型重症肌无力患者行胸腺切除术后发生CSR的可能性较大。发病年龄和病程是影响预后的因素。

图.疾病持续时间(<12个月)在实现CSR方面的差异(对数秩Mantel-Cox,P=0.016)。
Fig.Desease duration (<12 months) differences in achieving CSR (Log-rank Mantel-Cox, P =0.016).

Purpose: To compare the post-thymectomy prognosis in different conditions of myasthenia gravis (MG) patients with thymus hyperplasia.
Materials and methods: Collecting medical record and carrying out the follow-up study of 123 myasthenia gravis patients with thymus hyperplasia who have underwent thymectomy during the period between 2003 and 2013. Dividing into different groups based on gender, age of onset, duration of disease and Myasthenia Gravis Association of America (MGFA) clinical classification to analyze different prognosis in different groups.
Results: Complete stable remission (CSR) was achieved in 71 of 123 patients (59.5%). There is no gender-related difference in achieving CSR. Patients with early onset of MG (≤40 years old) or disease duration less than 12 months had significantly higher CSR rates than those with late onset of MG (>40 years old) or disease duration more than 12 months respectively, while no difference was found in remission rate between MGFA clinical classification I and MGFA II.
Conclusion: Myasthenia gravis patients with thymus hyperplasia who had thymectomy are proved to possess greater chance of achieving CSR. The onset age of disease and duration are the prognostic factors.
Yang J, Liu C, Li T, Li C. Prognosis of thymectomy in myasthenia gravis patients with thymus hyperplasia. Int J Neurosci. 2017 Sep;127(9):785-789. 

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