Wang Ru-wen, Jiang Yao-guang, Xue Zhi-qiang, Zhao Yun-ping, Ma Zheng
Center of Thoracic Surgery of PLA, Research Institute of Surgery, Daping Hospital, the Third Military Medical University, Chongqing 400042, China.
Zhonghua Wai Ke Za Zhi. 2004 May 7;42(9):536-9.
To explore the clinical characteristics and outcome of myasthenia gravis with and without thymoma after operation.
Two hundred and forty-three patients with myasthenia gravis surgically treated in our department from 1978 to 2003 were studied retrospectively. The clinical characteristics, complication, remission and survival were compared between myasthenia gravis with and without thymoma.
The patients of myasthenia gravis with thymoma were significantly older (t = 6.138, P = 0.000), had shorter duration of symptom (t = 3.783, P = 0.000), and also had higher myasthenia crisis rates after operation (chi(2) = 64.77, P = 0.000) than those of myasthenia gravis without thymoma. No differences of Osserman classification was found between the two groups (chi(2) = 7.678, P = 0.104). The complete remission rates and partial remission rates of myasthenia gravis with thymoma were significantly lower than those of myasthenia gravis without thymoma at 1 and 3 years (P = 0.049, P = 0.000; P = 0.015, P = 0.010), but no differences at 5 year (P = 0.457; P = 0.699). The survival rates of MG with thymoma were lower than that of MG without thymoma (Log-rank = 18.58, P = 0.000).
The clinical characteristics are different between myasthenia gravis with and without thymoma. The remission of symptom of myasthenia gravis with thymoma is worse than that of myasthenia gravis without thymoma in the near future, but is similar in the long future. The death rates of MG with thymoma is significantly higher than that of MG without thymoma.
探讨伴或不伴胸腺瘤的重症肌无力患者术后的临床特征及预后。
回顾性研究1978年至2003年在我科接受手术治疗的243例重症肌无力患者。比较伴胸腺瘤和不伴胸腺瘤的重症肌无力患者的临床特征、并发症、缓解情况及生存率。
伴胸腺瘤的重症肌无力患者年龄显著更大（t = 6.138，P = 0.零零零），症状持续时间更短（t = 3.783，P = 0.零零零），术后重症肌无力危象发生率也高于不伴胸腺瘤的患者（χ² = 64.77，P = 0.零零零）。两组间Osserman分型无差异（χ² = 7.678，P = 0.104）。伴胸腺瘤的重症肌无力患者在1年和3年时的完全缓解率和部分缓解率显著低于不伴胸腺瘤的患者（P = 0.049，P = 0.零零零；P = 0.015，P = 0.010），但5年时无差异（P = 0.457；P = 0.699）。伴胸腺瘤的重症肌无力患者生存率低于不伴胸腺瘤的患者（Log-rank = 18.58，P = 0.零零零）。
伴胸腺瘤和不伴胸腺瘤的重症肌无力患者临床特征不同。伴胸腺瘤的重症肌无力患者近期症状缓解情况比不伴胸腺瘤的患者差，但远期相似。伴胸腺瘤的重症肌无力患者死亡率显著高于不伴胸腺瘤的患者。
