Oosterhuis H J
Department of Neurology, State University Groningen, The Netherlands.
J Neurol Neurosurg Psychiatry. 1989 Oct;52(10):1121-7. doi: 10.1136/jnnp.52.10.1121.
A long term follow up study is presented of 73 patients with myasthenia gravis, living in Amsterdam between 1926 and 1965. In the period 1961-65 the annual incidence was 3.1, the prevalence 53 per million. Maximum severity of the disease occurred during the first seven years after onset in 87%. Eighteen (29%) patients died, of whom eight had a thymoma (TH). Spontaneous improvement or remission occurred at any time during the follow up. At the end of the study (1985) 16 (22%) patients were in a complete clinical remission, 13 (18%) had improved considerably (3 with prednisone), 12 (16%) had improved moderately, 12 (16%) had remained unchanged and two had deteriorated. If the early deaths are excluded the outcome is similar in the early and the late onset group without TH. Patients with TH had a less favourable course. Associated autoimmune diseases were diagnosed in 25% (n = 58). Because most of these patients were treated with anticholinesterases only, the evolution of their clinical state represents the natural course of MG.
本文呈现了一项对73例重症肌无力患者的长期随访研究，这些患者于1926年至1965年间居住在阿姆斯特丹。在1961 - 1965年期间，年发病率为3.1，患病率为每百万53例。87%的患者在发病后的前七年病情最为严重。18例（29%）患者死亡，其中8例患有胸腺瘤（TH）。在随访期间的任何时候都出现了自发改善或缓解。在研究结束时（1985年），16例（22%）患者达到完全临床缓解，13例（18%）有显著改善（3例使用泼尼松），12例（16%）有中度改善，12例（16%）病情未变，2例病情恶化。如果排除早期死亡病例，早发型和晚发型且无胸腺瘤的患者组结果相似。患有胸腺瘤的患者病程较差。25%（n = 58）的患者被诊断出患有相关自身免疫性疾病。由于这些患者大多数仅接受抗胆碱酯酶治疗，他们临床状态的演变代表了重症肌无力的自然病程。
