Ariatti Alessandra, Stefani Marina, Miceli Pietro, Benuzzi Francesca, Galassi Giuliana
Department of Neurosciences, and Department of Onco-Haematology, University Hospitals of Modena & Reggio Emilia , Italy.
Int J Neurosci. 2014 Jun;124(6):427-35. doi: 10.3109/00207454.2013.853664. Epub 2013 Nov 19.
We evaluate the factors predictive of prognosis in 91 Caucasian patients affected by ocular myasthenia gravis (OMG), followed at our Institution during an observational time, ranging from 12 to 240 months. The Myasthenia Gravis Foundation of America (MGFA) clinical classification was used to grade the disease severity. We considered as outcome measures the variation in two subscores, ocular (O-QMG) and nonocular (NO-QMG); the last one reflected bulbar, neck, extremity functions. None of the independent variables evaluated for association with the outcome, as age of onset, type of therapy, length of interval between first and last examinations, and presence of antibodies to acetylcholine receptors (AChR-Abs) significantly affected the evolution of O-QMG and of NO-QMG. Health-related quality of life (HRQol) was assessed in 63 patients. Variations of diplopia or ptosis did not affect significantly physical (PCS) or mental composite subscores (MCS) of the Short-Form Health Survey (SF-36). Human leukocyte antigen (HLA) genotyping was studied to explore whether HLA class I and II allelic distribution differed among MG patients and controls. None of the studied HLA alleles significantly differed between OMG patients and controls. Similarly, none of the alleles with frequencies higher than 15% either in OMG patients or in controls was significantly associated, after Bonferroni correction, with the presence or absence of anti-AChR-Abs in serum.
我们评估了91例患有眼肌型重症肌无力(OMG)的白种患者的预后预测因素,这些患者在我们机构接受了12至240个月的观察随访。采用美国重症肌无力基金会(MGFA)的临床分类对疾病严重程度进行分级。我们将两个子评分的变化作为结局指标,即眼部(O-QMG)和非眼部(NO-QMG);后者反映了延髓、颈部和肢体功能。所评估的与结局相关的独立变量,如发病年龄、治疗类型、首次和末次检查之间的间隔时间以及乙酰胆碱受体抗体(AChR-Abs)的存在,均未显著影响O-QMG和NO-QMG的进展。对63例患者进行了健康相关生活质量(HRQol)评估。复视或上睑下垂的变化对简短健康调查(SF-36)的身体(PCS)或精神综合子评分(MCS)没有显著影响。研究了人类白细胞抗原(HLA)基因分型,以探讨MG患者和对照组之间HLA I类和II类等位基因分布是否存在差异。在OMG患者和对照组之间,所研究的HLA等位基因均无显著差异。同样,在Bonferroni校正后,OMG患者或对照组中频率高于15%的等位基因均与血清中抗AChR-Abs的存在与否无显著关联。