【摘要】 目的研究伴甲状腺疾病的重症肌无力(MG)患者的临床特点。方法同期住院及门诊MG患者88例(均排除其他自身免疫性疾病),分为甲状腺正常组(61例)和伴甲状腺疾病组(27例),回顾性分析其资料,比较两组患者的一般情况、首发症状、临床分型、实验室检查、治疗及疗效等临床特点。结果伴甲状腺疾病MG组中女性比例明显高于甲状腺正常MG组(74.07%比44.26%,χ~2=6.685,P=0.01)。甲状腺正常MG组与伴甲状腺疾病MG组患者年龄、病程及首发症状比较差异无统计学意义(均P>0.05)。两组患者临床分型构成比差异有统计学意义(χ~2=6.441,P=0.011),伴甲状腺疾病MG组以全身型居多(85.19%)。伴甲状腺疾病MG组患者血清乙酰胆碱受体抗体(AChR-Ab)、乙酰胆碱酯酶抗体(AChE-Ab)水平高于甲状腺正常MG组[分别(1.583(1.265,2.528)比1.024(0.272,1.931),Z=-2.053,P=0.040;0.192(0.098,0.311)比0.100(0.058,0.202),Z=-2.418,P=0.016],血清肌肉特异性受体酪氨酸激酶抗体(Musk-Ab)水平低于甲状腺正常MG组[0.307(0.264,0.361)比0.352(0.295,0.429),Z=-2.069,P=0.039]。两组患者血清连接素抗体(Titin-Ab)、Ryanodine受体抗体(RyR-Ab)水平,重复电刺激阳性率和新斯的明试验阳性率,治疗前临床绝对评分及治疗有效率比较差异均无统计学意义(均P>0.05)。结论伴甲状腺疾病的MG患者以女性多见,全身型MG居多,且多有血清AChR-Ab、AChE-Ab滴度升高明显。更多还原

【Abstract】 Objective To research the clinical characteristics of the patients with myasthenia gravis(MG) and thyroid diseases. Methods Eighty-eight patients with MG in our hospital were included in the study. They were divided into 2 groups: MG patients with thyroid diseases(27 cases) and without thyroid disorders(61 cases). Patients with other autoimmune diseases were excluded.We retrospectively analyzed their medical records and conducted a comparison of some clinical characteristics of the two groups, including the general situations, initial symptoms, clinical classification, accessory examinations, treatment and efficacy.Results Female patients were more prevalent in the group with thyroid diseases than that without thyroid disorders(74.07% vs. 44.26%,χ~2=6.685,P=0.01). There was no statistically significant difference(P>0.05)in the aspects of age, disease course or initial symptom between the two groups. Considering the clinical classification, the proportion of generalized MG in the group with thyroid diseases(85.19%) was significantly larger than that in the other group(χ~2=6.441,P=0.01).Comparing the serum level of autoantibodies, anti-acetylcholine receptor antibody(AChR-Ab) and anti-acetylcholinesterase antibody(AChE-Ab) were notably higher in the group with thyroid diseases[1.583(1.265,2.528) vs. 1.024(0.272,1.931),Z=-2.053,P=0.040;0.192(0.098,0.311) vs. 0.100(0.058,0.202),Z=-2.418,P=0.016]). However, anti-muscle specific tyrosine kinase antibody(Musk-Ab) was remarkably lower in the group with thyroid diseases[0.307(0.264,0.361)vs. 0.352(0.295,0.429),Z=-2.069,P=0.039].There was no statistically significant difference in the positive rate of serumanti-Titin antibody, anti-ryanodine receptor antibody, neostigmine test or repetitive nerve stimulation in both groups(P>0.05). Also, the absolute clinical scores before therapy and the rate of treatment response showed no significant difference between the two groups.Conclusions The proportion of female patients and generalized MG patients, and the serum titers of AChR-Ab and AChE-Abare significantly increased in MG patients with thyroid diseases than those without thyroid disorders.更多还原