Werneck L C, Teive H A
Departamento de Clínica Médica, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba.
Arq Neuropsiquiatr. 1987 Dec;45(4):379-90. doi: 10.1590/s0004-282x1987000400004.
It is reported the study of 55 myasthenia gravis cases, with a review of the symptoms and signals, comparing initial symptoms ant those found at the time of the first evaluation. The mean age of the patients was 31.05 +/- 18.46 and the mean time of follow-up 5.88 +/- 5.47 years. Also the results of the diagnostic tests is reported, as well as the results of the treatment. The patients were treated with anticholinesterasics, corticosteroids, azathioprine, plasma-exchange and thymectomy. A statistical analysis with the chi-square test was unable to show a difference between the above procedures, regarding the definitive resolution of the disease. From the 55 cases, 9 (16.6%) had total remission, 41 (74.5%) remained with symptoms and need some kind of treatment, and 5 (9.09%) died (three patients with thymoma, one patient with congenital myasthenia gravis, severe kyphoscoliosis and pulmonary restriction, and one patient during the thymectomy procedure). It was found a relation between the signs of respiratory insufficiency, myasthenic crisis and thymoma only in the group of patients who died. A review about the diagnostic methods and treatment in the current days is made.
据报道，对55例重症肌无力患者进行了研究，回顾了症状和体征，比较了初始症状与首次评估时发现的症状。患者的平均年龄为31.05±18.46岁，平均随访时间为5.88±5.47年。还报告了诊断测试结果以及治疗结果。患者接受了抗胆碱酯酶药物、皮质类固醇、硫唑嘌呤、血浆置换和胸腺切除术治疗。采用卡方检验进行统计分析，未能显示上述治疗方法在疾病最终缓解方面存在差异。55例患者中，9例（16.6%）完全缓解，41例（74.5%）仍有症状且需要某种治疗，5例（9.09%）死亡（3例患有胸腺瘤，1例患有先天性重症肌无力、严重脊柱后凸和肺部受限，1例在胸腺切除术中死亡）。仅在死亡患者组中发现呼吸功能不全体征、肌无力危象与胸腺瘤之间存在关联。对当前的诊断方法和治疗进行了综述。
