CAJ | 학술논문

目的通过分析青少年重症肌无力(JMG)患者骨龄和身高的发育情况来探讨胸腺手术对JMG患者生长发育的影响.方法采用横断面研究方法,依次纳入2011年7月至2014年8月就诊于中山大学附属第一医院神经科门诊的80例JMG患者,收集临床资料,根据身高标准差分值(Ht SDS)和骨龄的分布情况,明确JMG患者是否伴有身高和骨龄的发育异常,采用相关性分析和线性回归分析的统计方法探讨影响JMG患者身高和骨龄的因素.结果 (1)JMG患者骨龄与实际年龄(CA)比较延迟(0.15±1.32)岁,身高标准差分值均值为(-1.25±1.03)分;(2)多因素线性回归分析显示发病年龄进入以骨龄延迟为因变量的回归方程(P =0.007),激素累积使用量进入以Ht CASDS为因变量的回归方程(P=0.043);(3)胸腺手术组患者身高和骨龄的分布与非手术组比较差异无统计学意义(P＞0.1).结论 (1)JMG患儿存在骨龄延迟和身高发育低于同龄正常水平;(2)发病年龄是骨龄延迟的影响因素,激素累积用量是身高发育受限的影响因素;(3)胸腺手术对MG患儿的骨龄和身高发育无明显影响.
목적 통과분석청소년중증기무력(JMG)환자골령화신고적발육정황래탐토흉선수술대JMG환자생장발육적영향.방법 채용횡단면연구방법,의차납입2011년7월지2014년8월취진우중산대학부속제일의원신경과문진적80례JMG환자,수집림상자료,근거신고표준차분치(Ht SDS)화골령적분포정황,명학JMG환자시부반유신고화골령적발육이상,채용상관성분석화선성회귀분석적통계방법탐토영향JMG환자신고화골령적인소.결과 (1)JMG환자골령여실제년령(CA)비교연지(0.15±1.32)세,신고표준차분치균치위(-1.25±1.03)분;(2)다인소선성회귀분석현시발병년령진입이골령연지위인변량적회귀방정(P =0.007),격소루적사용량진입이Ht CASDS위인변량적회귀방정(P=0.043);(3)흉선수술조환자신고화골령적분포여비수술조비교차이무통계학의의(P＞0.1).결론 (1)JMG환인존재골령연지화신고발육저우동령정상수평;(2)발병년령시골령연지적영향인소,격소루적용량시신고발육수한적영향인소;(3)흉선수술대MG환인적골령화신고발육무명현영향.
Objective To explore the effects of clinical indicators,particularly thymectomy on the development of juvenile myasthenia gravis (JMG) through the developmental status of bone age (BA) and height.Methods A cross-sectional study of 80 JMG patients was recruited to examine whether JMG patients had the abnormalities of height and bone development according to the distribution of height standard deviation score (Ht SDS) and BA.Results The mean BA was delayed by (0.15 ± 1.32) years compared with patient chronological age (CA).The mean Ht SDS (HtCA SDS-1.25 ± 1.03) was also lower than healthy controls.In multivariate analysis,the age at onset was negatively associated with delayed BA (P =0.007) whereas the cumulative intake of prednisone was negatively associated with HtCASDS (P =0.043).No significant correlation existed between thymectomy and delayed BA or HtCA SDS.Delayed BA and slow growth existed in JMG patients.The age at onset of JMG was a correlative factor for delayed BA.And the intake of cumulative prednisone might be a determinant of height retardation.Thymectomy had no impact on the development of bone and height.Conclusion We should pay more attention to monitoring BA and height in JMG patients to take appropriate therapeutic interventions.