Barbaud A, Carlander B, Pagès M
Service de Neurologie A et Maladies Neurovasculaires, CHU Gui de Chauliac, Montpellier, France.
Rev Neurol (Paris). 2006 Oct;162(10):990-6. doi: 10.1016/s0035-3787(06)75109-8.
The incidence of myasthenia gravis appears to be increasing in elderly but few studies have been devoted to late onset myasthenia gravis.
We retrospectively compared myasthenic patients with an age at onset above or below 35 years which were observed in two departments of Neurology from 1980 to 2002.
81 cases were included, 28 of which were late onset myasthenia gravis. The two populations were similar in terms of sex-ratio, clinical symptoms, course of the disease and therapeutic response. There was a trend for older patients to present more frequently at onset with dysphagia and axial or proximal involvement, and to have extra-ocular symptoms more quickly. Antibodies against acetylcholine receptor and striated muscle were statistically more frequent in elder patients.
A late onset is not a factor of poor prognosis in myasthenia gravis and older patients must be treated in the same way than younger ones.
重症肌无力的发病率在老年人中似乎呈上升趋势，但针对晚发型重症肌无力的研究较少。
我们回顾性比较了1980年至2002年在两个神经科观察到的发病年龄在35岁及以上或以下的重症肌无力患者。
共纳入81例患者，其中28例为晚发型重症肌无力。两组患者在性别比例、临床症状、病程和治疗反应方面相似。老年患者发病时更常出现吞咽困难、轴性或近端受累，且眼外肌症状出现更快。老年患者中抗乙酰胆碱受体和横纹肌抗体在统计学上更为常见。
晚发型并非重症肌无力预后不良的因素，老年患者的治疗方式应与年轻患者相同。
