【摘要】 目的探讨眼肌型重症肌无力(OMG)病情进展的影响因素及预测指标。方法回顾性分析了200例OMG患者的临床资料,根据病情进展情况分为OMG组和全身型重症肌无力(GMG)组两组,并对两组临床特征和实验窒检查结果进行比较。结果 GMG组乙酰胆碱受体抗体(AChRAb)水平升高、单纤维肌电图异常以及胸腺瘤比例均高于OMG组(P<0.05)。Cox风险回归模型分析结果显示早期给予糖皮质激素和免疫抑制剂治疗能明显降低GMG发生的风险(分别RR=0.377、RR=0.193,均P<0.01),而AChRAb水平升高和合并胸腺瘤可以增加GMG发生的风险(分别RR=4.460、P<0.01,RR=2.113、P<0.05)。结论 AChRAb水平升高、合并胸腺瘤可促进OMG病情进展,有可能作为OMG进展为GMG的风险预测指标。早期糖皮质激素治疗以及长期口服免疫抑制剂治疗有可能延缓OMG病情向GMG进展。更多还原

【Abstract】 Objective To identify the predictors and influencing factors of cular myasthenia gravis (OMG) conversing to secondary generalized myasthenia gravis (GMG). Methods We reviewed an OMG database of 200 patients. They were divided into two subgroups according to their prognosis: OMG group and GMG group. Clinical characteristics and laboratory findings were both compared between the two groups. Results High level of AChR antibody, abnormal single fiber electromyography (SFEMG) and thymoma were more frequently observed in the GMG group than in the OMG group. Cox proportional hazards regression analysis showed that early corticosteroids and immunosuppressants therapy significantly reduced the risk of secondary GMG (RR=0.377, P<0.01; RR=0.193, P<0.01), whereas abnormal AChR antibody and thymoma had an impact on the risk of developing generalized disease in patients presenting with OMG (RR=4. 460, P<0.01; RR=2.113, P<0.05). Conclusions Our findings suggested that AChR antibody, thymoma were predictive of the development of secondary generalization. Early corticosteroids and immunosuppressants therapy might reduce the risk of secondary generalization.更多还原