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胸腺切除术治疗重症肌无力的疗效及其影响因素分析
  • ISSN号:1006-2963
  • 期刊名称:《中国神经免疫学和神经病学杂志》
  • 时间:0
  • 分类:R746.1[医药卫生—神经病学与精神病学;医药卫生—临床医学]
  • 作者机构:陕西省西安市第四军医大学唐都医院神经内科,710038
  • 相关基金:国家自然科学基金资助项目(81102217)
中文摘要:

目的总结行胸腺切除术的重症肌无力(MG)患者的疗效,并探讨影响近远期疗效的相关因素。方法回顾性分析作者医院收治的103例行胸腺切除术的MG患者的临床资料,采用卡方检验及Logistic回归分析可能影响疗效的因素。MG患者的近期及远期疗效分别用Monden、美国重症肌无力联盟(MGFA)分型进行评估。结果 103例患者中完成随访94例(91.26%),随访时间3个月~8年。近期疗效总有效率为60.2%,远期疗效总有效率为73.4%。发病年龄、性别、Osserman分型与术后近远期疗效均无相关(P〉0.05);病程(OR=0.240、95%CI:0.081~0.712,P〈0.05)、手术方式(OR=0.289、95%CI:0.110~0.757,P〈0.05)与近期疗效密切相关,是否合并胸腺瘤与远期疗效密切相关(OR=0.073、95%CI:0.009~0.575,P〈0.05)。结论病程越短,手术近期疗效越好;行胸腔镜手术较开胸手术能明显提高患者近期预后;MG不合并胸腺瘤者行胸腺切除术较合并胸腺瘤的患者更能从手术中获益。

英文摘要:

Objective To summarize the effect of thymectomy in patients with myasthenia gravis (MG), and to evaluate the factors influencing the short- and long-term outcome. Methods Clinical data of 103 MG patients underwent thymectomy in authors' hospital was retrospectively analyzed, and chi-squared test and logistic regression model were performed to analyze the related prognostic factors. The short- and the long-term effect were determined based on Monden and MGFA classification respectively. Results Among the 103 cases, 94 (91. 26%) were followed up and the follow-up time was between three months and eight years. The total effective rates of short-and the long-term effect were 60.2% and 73.4%, respectively. The onset age, gender and the Osserman type had no correlation with short- and long-term outcomes (P〉0.05). Duration of symptoms (OR=0.240, 95%CI: 0.081-0.712, P〈0.05) and surgical procedures (OR=0.289, 95%CI: 0.110-0.757, P%0.05) had significant correlations with short-term effect. Combined with thymoma or not had significant correlations with long-term effect (OR=0. 073, 95% CI: 0. 009-0. 575, P〈0.05). Conclusions Thymectomy can lead to better prognosis in shorter disease duration. The efficacy in patients who undergo thoracoscopic surgery is better than that in ones who undergo thoracic surgeryoperation. MG patients without thymoma benefit more from operation than the ones who have thymoma.

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期刊信息
  • 《中国神经免疫学和神经病学杂志》
  • 中国科技核心期刊
  • 主管单位:中华人民共和国卫生部
  • 主办单位:卫生部北京医院 中国免疫学会神经免疫学分会
  • 主编:陈海波 胡学强
  • 地址:北京东城区大佛寺东街6号
  • 邮编:100010
  • 邮箱:zgsm@263.net
  • 电话:010-64012981-8110
  • 国际标准刊号:ISSN:1006-2963
  • 国内统一刊号:ISSN:11-3552/R
  • 邮发代号:82-718
  • 获奖情况:
  • 在首届《中国学术期刊(光盘版)检索与评价数据规...
  • 国内外数据库收录:
  • 美国化学文摘(网络版),中国中国科技核心期刊,中国北大核心期刊(2011版)
  • 被引量:7625