中国神经精神疾病杂志
中國神經精神疾病雜誌
중국신경정신질병잡지
CHINESE JOURNAL OF NERVOUS AND MENTAL DISEASES
2014年
2期
83-86
,共4页
重症肌无力%胸腺瘤%甲亢%预后
重癥肌無力%胸腺瘤%甲亢%預後
중증기무력%흉선류%갑항%예후
Myasthenia gravis%Thymoma%Hyperthyroidism%Prognosis
目的：建立预测眼肌型起病的重症肌无力患者（ocular myasthenia gravis, OMG）预后的临床评分方法。方法回顾性分析113例眼肌型起病的重症肌无力（myasthenia gravis, MG）患者临床资料，根据起病2年时病情进展情况将患者分为单纯眼肌型组(ocular myasthenia gravis, OMG)和进展为全身型组(general myasthenia gravis, GMG)，应用Logistic回归分析筛选影响OMG预后的影响因素，并根据影响因素的回归系数建立量化的预测OMG预后的临床评分方法。受试者工作曲线（receiver operator characteristic curve, ROC）验证评分方法的有效性并确定诊断界点。结果Logistic回归分析显示胸腺瘤（OR=4.005,95%CI 1.493~10.742）、甲状腺功能（OR=6.640,95%CI 2.553~17.25）是影响OMG预后的危险因素，评分方法总分数值为3分。ROC曲线下面积为76.6%，界点为1分，患者大于该分数值有进展为GMG的风险。界点为1分时该评分方法预测OMG预后的灵敏度为1，特异度为0.455，阳性预测值为73.9%，阴性预测值为59.1%。结论该评分方法在预测眼肌型MG预后方面切实有效，量化评分1分以上OMG患者2年内有进展为GMG的可能。
目的：建立預測眼肌型起病的重癥肌無力患者（ocular myasthenia gravis, OMG）預後的臨床評分方法。方法迴顧性分析113例眼肌型起病的重癥肌無力（myasthenia gravis, MG）患者臨床資料，根據起病2年時病情進展情況將患者分為單純眼肌型組(ocular myasthenia gravis, OMG)和進展為全身型組(general myasthenia gravis, GMG)，應用Logistic迴歸分析篩選影響OMG預後的影響因素，併根據影響因素的迴歸繫數建立量化的預測OMG預後的臨床評分方法。受試者工作麯線（receiver operator characteristic curve, ROC）驗證評分方法的有效性併確定診斷界點。結果Logistic迴歸分析顯示胸腺瘤（OR=4.005,95%CI 1.493~10.742）、甲狀腺功能（OR=6.640,95%CI 2.553~17.25）是影響OMG預後的危險因素，評分方法總分數值為3分。ROC麯線下麵積為76.6%，界點為1分，患者大于該分數值有進展為GMG的風險。界點為1分時該評分方法預測OMG預後的靈敏度為1，特異度為0.455，暘性預測值為73.9%，陰性預測值為59.1%。結論該評分方法在預測眼肌型MG預後方麵切實有效，量化評分1分以上OMG患者2年內有進展為GMG的可能。
목적：건립예측안기형기병적중증기무력환자（ocular myasthenia gravis, OMG）예후적림상평분방법。방법회고성분석113례안기형기병적중증기무력（myasthenia gravis, MG）환자림상자료，근거기병2년시병정진전정황장환자분위단순안기형조(ocular myasthenia gravis, OMG)화진전위전신형조(general myasthenia gravis, GMG)，응용Logistic회귀분석사선영향OMG예후적영향인소，병근거영향인소적회귀계수건립양화적예측OMG예후적림상평분방법。수시자공작곡선（receiver operator characteristic curve, ROC）험증평분방법적유효성병학정진단계점。결과Logistic회귀분석현시흉선류（OR=4.005,95%CI 1.493~10.742）、갑상선공능（OR=6.640,95%CI 2.553~17.25）시영향OMG예후적위험인소，평분방법총분수치위3분。ROC곡선하면적위76.6%，계점위1분，환자대우해분수치유진전위GMG적풍험。계점위1분시해평분방법예측OMG예후적령민도위1，특이도위0.455，양성예측치위73.9%，음성예측치위59.1%。결론해평분방법재예측안기형MG예후방면절실유효，양화평분1분이상OMG환자2년내유진전위GMG적가능。
Objective To establish a simple scale system to predict early risk of general myasthenia gravis (GMG) in patients with ocular myasthenia gravis (OMG). Methods We retrospectively analyzed clinical data of the patients with general myasthenia gravis with a definite ocular myasthenia gravis origin (n=113). The patients with OMG were divided into two groups (OMG and GMG) according to the disease progression within two years after onset of OMG. Logistic re-gression analysis was used to screen the influencing factors.The score was developed according to regression coefficients. The receiver operating characteristic (ROC) curve was first plotted. The ROC was then used to determine sensitivities and specificities of prediction. Results Logistic regression analysis revealed that thymoma (OR 4.005, 95%CI 1.493~10.742) and thyroid dysfunction (OR 6.640, 95 %CI 2.553~17.25) were the risk factors for the poor prognosis of OMG, and a three-point scale system was used to rate the risk of GMG in OMG patients. ROC was plotted and area under the curve (AUC) was 76.6%. One-point was set as the cutoff point with sensitivity of 1, specificity of 0.455,positive predictive val-ue 73.9%and negative predictive value 59.1%. OMG patients with score higher than 1 were at high risk for GMG. Con-clusions The present study has established a simple three-point scale system for the risk of GMG in patients with OMG. The scale system can be used in routine clinical practice to identify high-risk individuals with score higher than 1 al-though further validations are needed.
