Stankovic Milica, Peric Stojan, Stojiljkovic Tamas Olivera, Stankovic Tamara, Nikolic Ana, Lavrnic Dragana, Basta Ivana
School of Medicine, University of Belgrade, Belgrade, Serbia.
School of Medicine, Neurology Clinic, Clinical Centre of Serbia, University of Belgrade, Dr Subotica Starijeg 6, 11 000, Belgrade, Serbia.
Acta Neurol Belg. 2018 Sep;118(3):423-427. doi: 10.1007/s13760-018-0915-y. Epub 2018 Mar 28.
It is believed that myasthenia gravis (MG) with antibodies to muscle-specific tyrosine kinase (MuSK) is the most severe form of the disease, especially in the first years of the disease. The aim of our study was to investigate quality of life (QoL) in a population of patients with MuSK MG compared to those with MG who have antibodies to acetylcholine receptor (AChR) in their sera. The study group consisted of 35 MuSK MG patients (28 females and 7 males), while the control group included 38 AChR MG patients matched for gender, age, and duration of the disease. SF-36 questionnaire was used to evaluate the health-related QoL. Following scales were also used: Hamilton's scales for depression and anxiety, the Multidimensional Scale of Perceived Social Support, and the Acceptance of Illness Scale. Physical domain scores of QoL were similarly affected in both MuSK and AChR groups, while mental domain and total SF-36 scores were even better in MuSK MG patients. Social support was better in the MuSK group (77.3 ± 9.3 vs. 70.6 ± 14.1, p < 0.05). SF-36 total score correlated with depression (rho = 0.54, p < 0.01), anxiety (rho = 0.49, p < 0.01), and MSPSS (rho = - 0.35, p < 0.05), and depression was an independent predictor of worse QoL. Besides therapy of weakness, psychiatric treatment and different forms of psychosocial condition should be part of regular therapeutic protocols for MG. Adequate team work of health professionals and family can provide a healthy mental environment in which a MuSK MG patient would feel more comfortable in spite of the disease.
据信，伴有肌肉特异性酪氨酸激酶（MuSK）抗体的重症肌无力（MG）是该病最严重的形式，尤其是在疾病的最初几年。我们研究的目的是调查与血清中含有抗乙酰胆碱受体（AChR）抗体的MG患者相比，MuSK MG患者群体的生活质量（QoL）。研究组由35例MuSK MG患者（28名女性和7名男性）组成，而对照组包括38例在性别、年龄和病程方面匹配的AChR MG患者。使用SF-36问卷评估与健康相关的生活质量。还使用了以下量表：汉密尔顿抑郁和焦虑量表、多维感知社会支持量表以及疾病接受量表。MuSK组和AChR组的生活质量身体领域得分受到类似影响，而MuSK MG患者的心理领域和SF-36总分甚至更好。MuSK组的社会支持更好（77.3±9.3对70.6±14.1，p<0.05）。SF-36总分与抑郁（rho = 0.54，p<0.01）、焦虑（rho = 0.49，p<0.01）和MSPSS（rho = -0.35，p<0.05）相关，抑郁是生活质量较差的独立预测因素。除了肌无力治疗外，心理治疗和不同形式的心理社会状况应成为MG常规治疗方案的一部分。健康专业人员和家庭的充分团队合作可以提供一个健康的心理环境，使MuSK MG患者尽管患病仍会感觉更舒适。
