与重症肌无力急性恶化相关的因素。

Factors associated with acute exacerbations of myasthenia gravis.

机构信息

University of Missouri School of Medicine, Columbia, Missouri.

Health Management and Informatics, University of Missouri School of Medicine, Columbia, Missouri.

出版信息

Muscle Nerve. 2019 Dec;60(6):693-699. doi: 10.1002/mus.26689. Epub 2019 Sep 10.

DOI:10.1002/mus.26689

PMID:31469909

Abstract

INTRODUCTION

The etiology of acute exacerbations of myasthenia gravis (MG) is not well understood and further characterization can lead to improved preventative measures. This study aims to characterize factors contributing to MG exacerbations.

METHODS

A total of 127 MG patient charts were reviewed retrospectively (2011-2016) to obtain demographics, immunizations, pharmaceutical records, contributing factors of each MG exacerbation, emergency department (ED) visits, hospitalizations, and duration.

RESULTS

There were 212 exacerbations requiring 106 ED visits and 141 hospitalizations (average admission 6.5 days). Highest contributors were infections (30%) and medications that may worsen MG (19%), with 24% unattributed. Infection related exacerbations were associated with 44.3% of ED visits and 39.7% of hospitalizations. Patients prescribed beta-blockers were associated with more exacerbations (P < .01). Patients prescribed medications that may worsen MG had a higher exacerbation frequency shortly after administration.

DISCUSSION

Infections and cautioned medications are frequently factors in acute MG exacerbations needing urgent medical attention and warrant caution.

摘要

简介

重症肌无力（MG）急性加重的病因尚不清楚，进一步的特征描述可以导致预防措施的改进。本研究旨在描述导致 MG 加重的因素。

方法

回顾性分析了 127 例 MG 患者的病历（2011-2016 年），以获得人口统计学、免疫接种、药物记录、每个 MG 加重的促成因素、急诊科就诊、住院和持续时间。

结果

共发生 212 次需要 106 次急诊科就诊和 141 次住院的加重事件（平均住院时间 6.5 天）。最高的促成因素是感染（30%）和可能加重 MG 的药物（19%），24%归因不明。与感染相关的加重与 44.3%的急诊科就诊和 39.7%的住院治疗有关。服用β受体阻滞剂的患者发生加重的频率更高（P<0.01）。服用可能加重 MG 的药物的患者在用药后不久加重的频率更高。