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儿童重症肌无力伴甲状腺功能亢进88例临床分析

The clinical analysis of 88 juvenile patients with myasthenia gravis complicated by hyperthyroidism

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【作者】 占克斌卜碧涛杨明山张宇红曹小丽刘颖唐冰衫

【Author】 Zhan Kebin, Bu Bitao, Yang Mingshan, et al. Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030

【机构】 华中科技大学同济医学院附属同济医院神经内科华中科技大学同济医学院附属同济医院神经内科 430030武汉430030武汉

【摘要】 目的 研究儿童重症肌无力 (MG)伴甲状腺功能亢进症 (甲亢 )的临床特点及治疗。方法 对88例儿童MG伴甲亢患者的临床资料和治疗方法进行回顾性研究 ,并与同时期成人MG伴甲亢患者进行比较。结果 男性 35例 ,女性 5 3例 ;就诊时MG患者Ⅰ型 72例 ,ⅡA型 8例 ,ⅡB型 6例 ,Ⅳ型 2例 ;先有甲亢后有MG18例 ,先有MG后有甲亢 34例 ,MG和甲亢同时发生 36例 ;合并癫痫 6例 ,伴胸腺增生 16例 ;经过治疗 6 0 .2 3%的患者痊愈 ,7.95 %的患者无效。结论 儿童与成年人MG合并甲亢患者在性别上发病无统计学差异 ,而临床类型分布不同 ,儿童组以Ⅰ型多见 ;两种疾病的发生顺序不同 ,儿童先发生甲亢者较少 ,成人组先发生甲亢者多见。儿童MG伴甲亢患者的临床表现复杂 ,诊断较难 ,容易误诊和漏诊 ,提高对本病的认识是改善预后的关键。

【Abstract】 Objective To evaluate the clinical features and management of juvenile patients with myasthenia gravis(MG) complicated by hyperthyroidism(HT).Methods By using retrospective analysis, the clinical materials and therapeutic methods of 88 MG cases associated with HT were studied and compared with the adult patients.Results Among 2483 MG patients studied in the department of neurology, 88 juvenile MG patients were identified, including the male 35 and the female 53. Upon initial evaluation, the patients with type Ⅰ were 72 cases, type ⅡA 8, type ⅡB 6, and type Ⅳ 2. Concerning the onset time of the 2 disorders, 18 cases presented HT antecedently, 34 experienced MG antecedently, and 34 cases developed the two diseases simultaneously. In addition, 6 cases were complicated with epilepsy, and 16 cases with thymal hyperplasia. After treatment, 60.23% of cases had good recovery, and 7.95% had no improvement.Conclusions Juvenile and adult patients with MG complicated by HT showed no difference in sex distribution. In light of clinical types, majority of juvenile cases were in type Ⅰ. Juvenile cases much less present HT first than adult cases. The clinical manifestation of juvenile patients with MG associated with HT varies and misdiagnosis not uncommon. Accurate diagnosis is the key in improving the outcome of the disease.

  • 【文献出处】 卒中与神经疾病 ,Stroke and Nervous Diseases , 编辑部邮箱 ,2004年01期
  • 【分类号】R746.1
  • 【被引频次】7
  • 【下载频次】178
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