新加坡眼肌型重症肌无力向全身型转化的转化率低。

Low conversion rate of ocular to generalized myasthenia gravis in Singapore.

机构信息

Singapore National Eye Centre.

Singapore National Eye Centre, Singapore Eye Research Institute and Duke-NUS, Singapore.

出版信息

Muscle Nerve. 2018 May;57(5):756-760. doi: 10.1002/mus.25983. Epub 2017 Nov 2.

DOI:10.1002/mus.25983

PMID:28981152

Abstract

INTRODUCTION

Ocular myasthenia gravis (OMG) is a common condition of the neuromuscular junction that may convert to generalized myasthenia gravis (GMG). Our aim in this study was to determine the conversion rate and predictive factors for generalization in OMG, in an Asian population.

METHODS

The investigation consisted of a retrospective study of OMG patients with a minimum 2 years of follow-up.

RESULTS

Among 191 patients with OMG, 155 had the minimum 2-year follow-up. The conversion rate at median follow-up (40.8 months) was 10.6% (95% confidence interval 7.9%-13.3%), and at the 2-year follow-up it was 7.7% (95% confidence interval 5.6%-9.8%). At baseline, the predictive factors for generalization were positive acetylcholine receptor antibodies (hazard ratio 3.71, P = 0.024), positive repetitive nerve stimulation (RNS) studies (hazard ratio 4.42, P = 0.003), and presence of radiologically presumed or pathologically confirmed thymoma (hazard ratio 3.10, P = 0.013).

DISCUSSION

The conversion rate of OMG to GMG in Asian patients is low, as predicted by presence of acetylcholine receptor antibodies, presence of thymoma, and positive RNS studies. Muscle Nerve 57: 756-760, 2018.

摘要

简介

眼肌型重症肌无力（OMG）是神经肌肉接头的一种常见病症，可能会转化为全身性重症肌无力（GMG）。我们在这项研究中的目的是确定在亚洲人群中 OMG 向 GMG 转化的发生率和预测因素。

方法

该研究为回顾性研究，纳入了至少有 2 年随访的 OMG 患者。

结果

在 191 例 OMG 患者中，有 155 例患者随访时间达到了最低 2 年。在中位数随访（40.8 个月）时的转化率为 10.6%（95%置信区间 7.9%-13.3%），在 2 年随访时的转化率为 7.7%（95%置信区间 5.6%-9.8%）。在基线时，预测 GMG 转化的因素为乙酰胆碱受体抗体阳性（风险比 3.71，P = 0.024）、重复神经刺激（RNS）阳性（风险比 4.42，P = 0.003）和影像学提示或病理证实胸腺瘤（风险比 3.10，P = 0.013）。