CAJ | 학술논문

目的分析重症肌无力(MG)合并胸腺瘤患者的临床特点.方法回顾性分析2008年7月至2010年12月住院856例重症肌无力患者.依据胸腺情况分为胸腺瘤MG组(162例)和非胸腺瘤MG组(694例),比较两组患者性别构成、发病年龄、临床分型、肌无力危象发生率,进一步评价胸腺瘤病理分型、手术分期与MG临床严重程度的相关性.结果合并胸腺瘤MG患者占同期住院的18.9％,男女比例1.38∶1；发病年龄为(42.9 ± 12.4)岁,以中老年人群为主.伴发胸腺瘤MG患者全身型比例明显高于眼肌型(90.1％比62.4％,P＜0.001),由眼肌受累向全身转化平均病程仅为6.8个月,而非胸腺瘤患者组为17个月(P＜0.01).伴胸腺瘤者肌无力危象发生率远高于非胸腺瘤患者(14.8％比2.3％).MG伴发的胸腺瘤病理分型以B2型多见,手术Maosaoka分期以Ⅰ、Ⅱ期为主.不同病理类型胸腺瘤其临床分型差异无统计学意义.结论 MG伴发胸腺瘤患者以男性多见,病情重,进展快,出现肌无力危象比例高；伴发的胸腺瘤以B2型、Ⅱ期为主；不同的病理分型与MG临床分型无关.
목적 분석중증기무력(MG)합병흉선류환자적림상특점.방법 회고성분석2008년7월지2010년12월주원856례중증기무력환자.의거흉선정황분위흉선류MG조(162례)화비흉선류MG조(694례),비교량조환자성별구성、발병년령、림상분형、기무력위상발생솔,진일보평개흉선류병리분형、수술분기여MG림상엄중정도적상관성.결과 합병흉선류MG환자점동기주원적18.9％,남녀비례1.38∶1；발병년령위(42.9 ± 12.4)세,이중노년인군위주.반발흉선류MG환자전신형비례명현고우안기형(90.1％비62.4％,P＜0.001),유안기수루향전신전화평균병정부위6.8개월,이비흉선류환자조위17개월(P＜0.01).반흉선류자기무력위상발생솔원고우비흉선류환자(14.8％비2.3％).MG반발적흉선류병리분형이B2형다견,수술Maosaoka분기이Ⅰ、Ⅱ기위주.불동병리류형흉선류기림상분형차이무통계학의의.결론 MG반발흉선류환자이남성다견,병정중,진전쾌,출현기무력위상비례고；반발적흉선류이B2형、Ⅱ기위주；불동적병리분형여MG림상분형무관.
Objective To investigation the clinical characteristics in myasthenia gravis (MG)patients with thymomas.Methods A total of 856 MG patients admitted to the department during 2008.7-2010.12 were reviewed retrospectively.The patients with MG were divided into two groups based on thymic pathology,which were 162 cases with thymoma and 694 cases without thymoma.We compared the different clinical features including the gender,age of onset,MG symptoms and the incidence rate of myasthenia crisis.And the relationship between the WHO types,Maosaoka stages of thymoma and the severe of MG was also studied.Results The percentage of thymoma-associated MG patients was 18.9 percent of hospitalized MG patients at the same period.Of the 162 thymoma-associated patients,94 were male and 68 were female,with a ratio of 1.38∶1 and a mean age of (42.9 ± 12.4)years old.Thymoma was more frequent in middle-old aged patients than in children.Compared with non-thymoma MG,more thymomatous patients showed generalised MG,but not only ocular muscles weakness (90.1％ vs 62.4％,P ＜ 0.001 ).There were significant differences of the incidence rate of myasthenic crisis in the two groups ( 14.8％ vs 2.3％ ).(2)WHO type B2 and Maosaoka Ⅰ,Ⅱ thymoma were the commonest types among all potentially MG-associated thymoma.No differences of Osserman MG classification was found in thymomatous patients with different pathologic changes.Conclusions The thymomatous MG patients had its distinctive clinical features:thymomas occured in about 19.7％ of MG patients with more men than women,more common in generalized,higher incidence of myasthenia crisis,with B2 type thymic pathology and Maosaoka Ⅰ,Ⅱstages.No correlation was found between pathologic and clinical stagcs.