Kotov S V, Sidorova O P
Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia.
Zh Nevrol Psikhiatr Im S S Korsakova. 2016;116(11):103-105. doi: 10.17116/jnevro2016116111103-105.
The analysis of fatal outcomes of myasthenic crisis in patients with myasthenia.
The data on 19 patients with myastheniccrisis admitted at the Moscow Regional Research and Clinical Institute («MONIKI») over 12 years (1997-2009) have been summarized.
There are more than 600 patients with myasthenia in the Moscow region, including 13% patients with onset after 60 years. Seventeen patients of 19 were in the intensive care unit. Total death occurred in 7 cases (36.6%). Myocardial infarction, bilateral confluent pneumonia and hemorrhagic pulmonary edema caused death. All patients had concomitant diseases: hypertension, myocardial changes, hyperglycemia and others. Steroids and plasmapheresis were used for treatment of myasthenic crisis. The authors believe that methods of treatment of myasthenic crisis that does not lead to complications in elderly age and are suitable for patients with concomitant diseases, who can't be treated with glucocorticoids and plasmapheresis, should be used in clinical neurology. Normal human intravenous immunoglobulin is recommended in these cases.
分析重症肌无力患者肌无力危象的致死结局。
总结了12年间（1997 - 2009年）莫斯科地区研究与临床研究所（“MONIKI”）收治的19例肌无力危象患者的数据。
莫斯科地区有600多名重症肌无力患者，其中13%的患者发病于60岁之后。19例患者中有17例入住重症监护病房。7例（36.6%）患者死亡。心肌梗死、双侧融合性肺炎和出血性肺水肿导致死亡。所有患者都伴有其他疾病：高血压、心肌病变、高血糖等。使用类固醇和血浆置换治疗肌无力危象。作者认为，临床神经学应采用在老年患者中不会导致并发症且适用于不能使用糖皮质激素和血浆置换治疗的合并其他疾病患者的肌无力危象治疗方法。在这些情况下，推荐使用正常人静脉注射免疫球蛋白。
