胸腺瘤切除术后出现重症肌无力。

Myasthenia gravis appearing after thymectomy.

机构信息

Department of Neurology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410008, Hunan, China.

出版信息

J Clin Neurosci. 2011 Jan;18(1):57-60. doi: 10.1016/j.jocn.2010.05.018.

DOI:10.1016/j.jocn.2010.05.018

PMID:20888239

Abstract

We aimed to evaluate the clinical characteristics of patients with postoperative myasthenia gravis (MG). We retrospectively studied the data of 174 thymoma patients treated between 1990 and 2008 in Xiangya Hospital. Six of 125 patients without preoperative MG (4.8%) developed postoperative MG. The anti-acetylcholine-receptor binding antibody (ARAb) titers were elevated preoperatively in 22 of the 125 patients (17.6%) who did not have preoperative MG (range, 0.5-67.6nmol/L). Four of six patients with postoperative MG had positive ARAb levels preoperatively. Serum titers were exacerbated in all six patients at the onset of postoperative MG. Postoperative MG was responsive to anti-cholinesterase compounds and/or steroids. We concluded that a thymectomy did not prevent postoperative MG. Exacerbated ARAb levels after thymectomy suggested an extrathymic production of ARAb. We suggest that a rise in the ARAb titer might be a risk indictor for post-thymectomy MG.

摘要

我们旨在评估术后重症肌无力（MG）患者的临床特征。我们回顾性研究了 1990 年至 2008 年在湘雅医院治疗的 174 例胸腺瘤患者的数据。125 例术前无 MG 的患者中，有 6 例（4.8%）发生术后 MG。术前无 MG 的 125 例患者中有 22 例（17.6%）的抗乙酰胆碱受体结合抗体（ARAb）滴度升高（范围为 0.5-67.6nmol/L）。术后 MG 的 6 例患者中有 4 例术前存在阳性 ARAb 水平。在术后 MG 发病时，所有 6 例患者的血清滴度均加重。术后 MG 对抗胆碱酯酶化合物和/或类固醇有反应。我们得出结论，胸腺切除术不能预防术后 MG。胸腺切除术后 ARAb 水平升高提示 ARAb 的胸外产生。我们建议 ARAb 滴度升高可能是术后 MG 的风险指标。