Bouchikh M, El Malki H O, Ouchen F, Achir A, Benosman A
Service de chirurgie thoracique, CHU Ibn Sina, BP 353, Rabat principale 10001, Maroc; Centre de recherche en épidémiologie clinique et essais thérapeutiques (CRECET), faculté de médecine et de pharmacie de Rabat, université Mohamed V Souissi, Angle avenue Allal El Fassi et Mfadel Cherkaoui, Al Irfane 8007, N.U, Rabat, Maroc.
Rev Neurol (Paris). 2013 Nov;169(11):879-83. doi: 10.1016/j.neurol.2013.01.625. Epub 2013 Apr 29.
The aim of this study was to compare the characteristics of myasthenic patients with and without thymoma, and the results of thymectomy in both types of patients.
A retrospective study was conducted among 66 patients who underwent thymectomy for myasthenia gravis in our department over a 10-year period (2000-2010). The surgical approach was sternotomy or anterolateral thoracotomy. Patients were divided into two groups according to the presence of thymoma: with (T-MG) and without (NT-MG) thymoma. Complete stable remission (CSR) was the primary endpoint.
Median age was 35.09±9.89 years. The NT-MG group had 38 patients (57.57%) and the T-MG group 28 patients (42.43%). There was no difference between the two groups regarding the surgical approach (P=0.52). T-MG patients were older (40.54±15.16 vs. 31.37±9.46) (P=0.008) and predominantly male. There were more generalized forms (P=0.01) and more bulbar involvement (P=0.02) in the T-MG group. The rate of CSR at 5 years was 7% and 17% in the T-MG and NT-MG patients respectively (P=0.70). At 10 years, it was 36% and 94.73% respectively (P=0.03).
Thymomatous myasthenia gravis is characterized by the severity of its clinical features. Remission rate at 10 years was significantly lower in the myasthenia with thymoma group.
本研究旨在比较伴胸腺瘤和不伴胸腺瘤的重症肌无力患者的特征，以及两类患者胸腺切除术的结果。
对在我们科室10年期间（2000 - 2010年）因重症肌无力接受胸腺切除术的66例患者进行回顾性研究。手术方式为胸骨切开术或前外侧开胸术。根据是否存在胸腺瘤将患者分为两组：有胸腺瘤组（T - MG）和无胸腺瘤组（NT - MG）。完全稳定缓解（CSR）是主要终点。
中位年龄为35.09±9.89岁。NT - MG组有38例患者（57.57%），T - MG组有28例患者（42.43%）。两组在手术方式上无差异（P = 0.52）。T - MG组患者年龄较大（40.54±15.16对31.37±9.46）（P = 0.008），且以男性为主。T - MG组中全身型更多（P = 0.01），延髓受累更多（P = 0.02）。T - MG组和NT - MG组患者5年时的CSR率分别为7%和17%（P = 0.70）。10年时，分别为36%和94.73%（P = 0.03）。
胸腺瘤型重症肌无力的临床特征较为严重。伴胸腺瘤的重症肌无力组10年缓解率显著较低。
