摘要
目的探讨影响眼肌型重症肌无力(OMG)患者向全身型重症肌无力(GMG)转化的可能因素,以指导治疗疾病。方法纳入OMG患者420例,行持续门诊随访,将在随访中表现出眼外肌以外肌群受累的患者104例纳为观察组,将在末次门诊随访时仍维持OMG不变的患者316例纳为对照组。统计对比两组的一般资料、首发症状、眼部体征等。结果观察组中延髓型转化比例最高,占80.8%(84/104),69例患者在2年内发生转换,占66.3%,起病年龄与转换时间呈线性负相关(rs=-0.573,P<0.05);与对照组相比,观察组的起病年龄明显更大,面神经、副神经、尺神经异常率明显更高,胸腺瘤发病率明显更高,胸腺增生发病率明显更低,接受激素治疗的患者明显更少,上述差异均有统计学意义(P<0.05)。结论年龄、肢体近端肌肉低频RNS异常、胸腺瘤及早期激素治疗等因素可能与OMG向GMG转化有关。
Objective To explore the factors affecting the progression from ocular myasthenia gravis （OMG） to generalized myasthenia gravis （GMG）, so as to guide the treatment of disease. Methods A total of 420 cases of OMG patients were selected. All cases received outpatient follow-up continuously. 104 cases of patients with muscle involvement outside the ocular muscle were set as the observation group, and 316 cases of patients with remained OMG at the end of followed-up were set as the control group. The general information, initial symptoms and eye signs of two groups were statistically compared. Results The medulla type conversion ratio in the observation group was highest, accounting for 80.8% （84/104）; 66.3% （69/104） of GMG conversion occurred within 2 years, and the onset age was linear negatively correlated with the transition time （rs = -0.573, P〈0.05）. Compared with the control group, the observation group had higher onset age, higher abnormal rates of facial nerve, accessory nerve and ulnar nerve, higher incidence of thymoma, lower incidence of thymic hyperplasia, and less proportion of patients with hormone therapy, all the differences between two groups were statistically significant （P 〈0.05）. Conclusions The age, abnormal RNS of proximal limb muscles, thymoma and early hormone therapy may relate to the OMG to GMG transformation.
出处
《临床医学工程》
2016年第8期1061-1062,共2页
Clinical Medicine & Engineering
关键词
重症肌无力
眼肌麻痹
预后
临床特征
Myasthenia gravis
Ophthalmoplegia
Prognosis
Clinical characteristics
