Premuzic Vedran, Bilic Ervina, Sepec Branimir Ivan, Hancevic Mirea, Bilic Hrvoje, Sitas Barbara, Sprljan Alfirev Rujana, Jelakovic Bojan
Department of Nephrology, Hypertension, Dialysis and Transplantation.
Department of Neurology, University Hospital Centre Zagreb, Zagreb, Croatia.
Medicine (Baltimore). 2020 Feb;99(6):e19100. doi: 10.1097/MD.0000000000019100.
The aims were to determine the impact of dysphagia and glomerular filtration rate (GFR) in the prediction of myasthenia relapse and analyse whether different number of plasma exchange sessions could prolong the time before future relapse.This was a retrospective, longitudinal follow-up study with 60 enrolled patients. The patients were followed-up for a total of 50 months.Patients without relapses had significantly higher GFR and higher number of plasma exchange sessions when compared to patients with relapses. Mean time before next myasthenia relapse was significantly longer in patients with GFR ≥ 60 mL/min. Time before next and number of following myasthenia relapses were significantly higher in patients with symptoms of dysphagia.Decline in GFR levels is strongly associated with the presence of dysphagia and independently impacts the onset of myasthenia relapses. Timely initiation of plasmapheresis therapy and adequate hydration of patients with prolonged dysphagia should be one of the treatment goals for clinicians treating this disease.
本研究旨在确定吞咽困难和肾小球滤过率（GFR）对重症肌无力复发预测的影响，并分析不同次数的血浆置换疗程是否能延长未来复发前的时间。这是一项对60例入组患者进行的回顾性纵向随访研究。患者总共随访了50个月。与复发患者相比，未复发患者的GFR显著更高，血浆置换疗程次数更多。GFR≥60 mL/min的患者下次重症肌无力复发前的平均时间显著更长。有吞咽困难症状的患者下次复发前的时间和后续复发次数显著更高。GFR水平下降与吞咽困难的存在密切相关，并独立影响重症肌无力复发的发生。及时开始血浆置换治疗以及对吞咽困难持续时间较长的患者进行充分补液应是治疗该疾病的临床医生的治疗目标之一。
