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
2015年
7期
385-388
,共4页
陈斌%赵利娜%侯江涛%琚星萌%刘凤斌
陳斌%趙利娜%侯江濤%琚星萌%劉鳳斌
진빈%조리나%후강도%거성맹%류봉빈
重症肌无力%自身免疫疾病%临床特点
重癥肌無力%自身免疫疾病%臨床特點
중증기무력%자신면역질병%림상특점
Myasthenia gravis%Autoimmune diseases%Clinical features
目的：分析35例伴其他自身免疫性疾病的重症肌无力患者（myasthenia gravis associates with other autoimmune disease, ADMG）的临床特点。方法共170例重症肌无力患者，分为ADMG组（35例）和不伴其他自身免疫性疾病重症肌无力组（maythenia gravis without other autoimmune disease, NADMG，135例），比较两组患者性别、发病年龄、重症肌无力分型、肌无力危象、胸腺异常、药物治疗、重症肌无力进展及复发等临床特点。结果 ADMG女性30例，占85.7%，较NADMG组（54.8%）多见（P＜0.001）；中位年龄为40岁（23～45岁），较NADMG组年轻（P=0.039）。眼肌型重症肌无力在ADMG组多见（45.7%vs.24.4%；P=0.013）。且AD?MG组胸腺增生较NADMG组常见（14.3% vs.1.5%；P=0.001）。而肌无力危象、胸腺瘤、药物治疗、眼肌型重症肌无力进展为全身型重症肌无力、1年内重症肌无力复发组间差异无统计学意义。进一步多因素分析表明，两组患者性别（OR=4.76，95%CI：1.64~13.77；P=0.004）、年龄（OR=0.96，95%CI：0.92~0.99；P=0.019）、眼肌型重症肌无力（OR=3.10，95%CI：1.30~7.41；P=0.011）、胸腺增生（OR=16.26，95%CI：2.22~119.11；P=0.006）差异具有统计学意义。结论 ADMG组患者多见于青年女性，表现为眼肌型重症肌无力，并伴发胸腺增生。
目的：分析35例伴其他自身免疫性疾病的重癥肌無力患者（myasthenia gravis associates with other autoimmune disease, ADMG）的臨床特點。方法共170例重癥肌無力患者，分為ADMG組（35例）和不伴其他自身免疫性疾病重癥肌無力組（maythenia gravis without other autoimmune disease, NADMG，135例），比較兩組患者性彆、髮病年齡、重癥肌無力分型、肌無力危象、胸腺異常、藥物治療、重癥肌無力進展及複髮等臨床特點。結果 ADMG女性30例，佔85.7%，較NADMG組（54.8%）多見（P＜0.001）；中位年齡為40歲（23～45歲），較NADMG組年輕（P=0.039）。眼肌型重癥肌無力在ADMG組多見（45.7%vs.24.4%；P=0.013）。且AD?MG組胸腺增生較NADMG組常見（14.3% vs.1.5%；P=0.001）。而肌無力危象、胸腺瘤、藥物治療、眼肌型重癥肌無力進展為全身型重癥肌無力、1年內重癥肌無力複髮組間差異無統計學意義。進一步多因素分析錶明，兩組患者性彆（OR=4.76，95%CI：1.64~13.77；P=0.004）、年齡（OR=0.96，95%CI：0.92~0.99；P=0.019）、眼肌型重癥肌無力（OR=3.10，95%CI：1.30~7.41；P=0.011）、胸腺增生（OR=16.26，95%CI：2.22~119.11；P=0.006）差異具有統計學意義。結論 ADMG組患者多見于青年女性，錶現為眼肌型重癥肌無力，併伴髮胸腺增生。
목적：분석35례반기타자신면역성질병적중증기무력환자（myasthenia gravis associates with other autoimmune disease, ADMG）적림상특점。방법공170례중증기무력환자，분위ADMG조（35례）화불반기타자신면역성질병중증기무력조（maythenia gravis without other autoimmune disease, NADMG，135례），비교량조환자성별、발병년령、중증기무력분형、기무력위상、흉선이상、약물치료、중증기무력진전급복발등림상특점。결과 ADMG녀성30례，점85.7%，교NADMG조（54.8%）다견（P＜0.001）；중위년령위40세（23～45세），교NADMG조년경（P=0.039）。안기형중증기무력재ADMG조다견（45.7%vs.24.4%；P=0.013）。차AD?MG조흉선증생교NADMG조상견（14.3% vs.1.5%；P=0.001）。이기무력위상、흉선류、약물치료、안기형중증기무력진전위전신형중증기무력、1년내중증기무력복발조간차이무통계학의의。진일보다인소분석표명，량조환자성별（OR=4.76，95%CI：1.64~13.77；P=0.004）、년령（OR=0.96，95%CI：0.92~0.99；P=0.019）、안기형중증기무력（OR=3.10，95%CI：1.30~7.41；P=0.011）、흉선증생（OR=16.26，95%CI：2.22~119.11；P=0.006）차이구유통계학의의。결론 ADMG조환자다견우청년녀성，표현위안기형중증기무력，병반발흉선증생。
Objective To analyze the clinical features of 35 patients with myasthenia gravis (MG) associated with other autoimmune diseases (ADMG). Methods One hundred seventy MG patients were divided into 2 groups. One group included MG patients with autoimmune diseases ( n=35), and the other included MG patients without auto?immune diseases (NADMG, n=135). Clinical features such as gender, age of onset, types of MG, myasthenic crisis, thy?mus abnormalities, different therapies, ocular MG progressing to general MG, and relapse of MG within one year were compared between ADMG and NADMG. Results 85.7%ADMG patients were female which was higher compared with NADMG (P< 0.001); median age of onset was 40 years old (23~45 years old) in ADMG group which was younger than NADMG group. Ocular MG and thymic hyperplasia were more frequent in ADMG group than in NADMG group (45.7%vs. 24.4%, P=0.013;14.3%vs. 1.5%,P=0.001,respectively). Other clinical features such as myasthenic crisis, thymoma, different therapies, ocular MG progressing to general MG, and relapse of MG within one year were not signifi?cantly different between the two groups. In multivariate analysis, female (OR=4.76, 95% CI:1.64-13.77; P= 0.004), age of onset (OR=0.96, 95%CI:0.92-0.99;P=0.019), ocular MG (OR=3.10, 95%CI:1.30-7.41;P=0.011) and thy? mic hyperplasia(OR=16.26, 95%CI:2.22-119.11;P=0.006) were significantly different between the two groups. Con?clusions ADMG is more common in female patients with ocular MG and thymic hyperplasia.
