Utsugisawa Kimiaki, Suzuki Shigeaki, Nagane Yuriko, Masuda Masayuki, Murai Hiroyuki, Imai Tomihiro, Tsuda Emiko, Konno Shingo, Nakane Shunya, Suzuki Yasushi, Fujihara Kazuo, Suzuki Norihiro
Department of Neurology, Hanamaki General Hospital, 4-28 Kajoh-chou, Hanamaki, 025-0075, Japan.
Muscle Nerve. 2014 Oct;50(4):493-500. doi: 10.1002/mus.24213. Epub 2014 Aug 30.
The aim of this study was to determine factors affecting health-related quality of life (HRQOL) and to propose appropriate treatment targets for patients with myasthenia gravis (MG).
We evaluated 640 consecutive patients with MG seen at 11 neurological centers. Two-year follow-up data were obtained for 282 patients. Correlations between detailed clinical factors and the Japanese version of the 15-item MG-specific QOL scale score were analyzed.
In a cross-sectional analysis of 640 MG patients, multivariate regression revealed that disease severity, as evaluated by the MG Composite (P<0.0001), total dose of oral prednisolone during the last year (P=0.002), and Cushingoid appearance index (P=0.0004), showed significant negative effects on HRQOL, but the quantitative MG score and current prednisolone dose did not.
Achieving minimal manifestations (MM) status or better with prednisolone ≤ 5 mg/day was found to exert a major positive impact on HRQOL in both the cross-sectional and 2-year follow-up patient samples and can be recommended as a treatment target.
本研究旨在确定影响重症肌无力（MG）患者健康相关生活质量（HRQOL）的因素，并为其提出合适的治疗目标。
我们评估了在11个神经科中心连续就诊的640例MG患者。获得了282例患者的两年随访数据。分析了详细临床因素与15项MG特异性生活质量量表日本版评分之间的相关性。
在对640例MG患者的横断面分析中，多因素回归显示，以MG综合评分评估的疾病严重程度（P<0.0001）、过去一年口服泼尼松龙的总剂量（P=0.002）和库欣样外观指数（P=0.0004）对HRQOL有显著负面影响，但定量MG评分和当前泼尼松龙剂量则无此影响。
在横断面和两年随访患者样本中，发现使用泼尼松龙≤5mg/天达到最小表现（MM）状态或更好状态对HRQOL有重大积极影响，可推荐作为治疗目标。
