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[重症肌无力早发型与晚发型的临床特征]

[The clinical characteristics of early-onset versus late-onset types of myasthenia gravis].

作者信息

Wang Wei, Chen Yu-Ping, Wei Dong-Ning

机构信息

Department of Neurology, Center for Myasthenia Gravis, Beijing, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2011 Jun;50(6):496-8. doi: 10.3760/cma.j.issn.0578-1426.2011.06.013.

Abstract

OBJECTIVE

To compare the clinical characteristics of early-onset and late-onset myasthenia gravis (MG).

METHODS

A total of 819 MG patients admitted in our department during the same period were reviewed retrospectively. The patients with MG were divided into two groups by the age of onset, which were the early-onset MG (< 49 years) and late-onset MG (≥ 50 years). Several clinical features were compared in the two groups including the percentage, initial symptoms, MG types, the positive rates of neostigmine test and repetitive nerve stimulation, thyroid function and thymic abnormalities.

RESULTS

The more common onset age of MG was 0 - 49 years (early-onset). In both groups the male and female ratio was closer to 1:1 with the extra ocular muscles weakness presented as the most frequent symptom and Type IIB presented as the most common type in both groups (41.51% and 51.37% respectively in early-onset and late-onset groups). Type I was more common in early-onset group while type IIB was more common in late-onset group (P < 0.05). There was no significant difference in the positive rates of neostigmine test and repetitive nerve stimulation between the two groups. The thyroid function abnormality ratio was higher in early-onset group. Hyperplastic thymus was common in early-onset group (67.57%) while both hyperplastic thymus and thymoma were common in late-onset group (48.68% and 47.37%).

CONCLUSIONS

The clinical characteristics of early-onset and late-onset myasthenia gravis (MG) was different in MG type, the positive rate of thyroid function abnormalities and thymic pathologic type.

摘要

目的

比较早发型和晚发型重症肌无力(MG)的临床特征。

方法

回顾性分析同期在我科住院的819例MG患者。根据发病年龄将MG患者分为两组,即早发型MG(<49岁)和晚发型MG(≥50岁)。比较两组的多项临床特征,包括百分比、初始症状、MG类型、新斯的明试验和重复神经电刺激的阳性率、甲状腺功能及胸腺异常情况。

结果

MG较常见的发病年龄为0 - 49岁(早发型)。两组的男女比例均接近1:1,最常见的症状均为眼外肌无力,两组中最常见的类型均为IIB型(早发型组和晚发型组分别为41.51%和51.37%)。I型在早发型组更常见,而IIB型在晚发型组更常见(P<0.05)。两组新斯的明试验和重复神经电刺激的阳性率无显著差异。早发型组甲状腺功能异常比例较高。早发型组胸腺增生常见(67.57%),而晚发型组胸腺增生和胸腺瘤均常见(分别为48.68%和47.37%)。

结论

早发型和晚发型重症肌无力(MG)在MG类型、甲状腺功能异常阳性率及胸腺病理类型方面临床特征不同。

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