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胸腺瘤和非胸腺瘤重症肌无力患者药物需求时间加权剂量的短期胸腺切除术后结局比较。

Comparison of Short-Term Post-Thymectomy Outcomes by Time-Weighted Dosages of Drug Requirements between Thymoma and Non-Thymoma Myasthenia Gravis Patients.

机构信息

Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.

Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand.

出版信息

Int J Environ Res Public Health. 2023 Feb 9;20(4):3039. doi: 10.3390/ijerph20043039.

Abstract

(1) Background: Early thymectomy is suggested in all clinically indicated myasthenia gravis (MG) patients. However, short-term clinical response after thymectomy in MG patients has been limitedly described in the literature. This study aimed to compare the 5-year post-thymectomy outcomes between thymoma (Th) and non-thymoma (non-Th) MG patients. (2) Methods: MG patients aged ≥18 years who underwent transsternal thymectomy and had tissue histopathology reports in Songklanagarind Hospital between 2002 and 2020 were enrolled in a retrospective review. The differences in the baseline demographics and clinical characteristics between ThMG and non-Th MG patients were studied. We compared the time-weighted averages (TWAs) of daily required dosages of pyridostigmine, prednisolone or azathioprine to efficiently maintain daily living activities and earnings between the MG patient groups during 5 consecutive years following thymectomy. Post-thymectomy clinical status, exacerbations or crises were followed. Descriptive statistics were used for analysis with statistical significance set at < 0.05. (3) Results: ThMG patients had significantly older ages of onset and shorter times from the MG diagnosis to thymectomy. Male gender was the only significant factor associated with ThMG. TWAs of the daily MG treatment drug dosages required showed no differences between the groups. Additionally, the rates of exacerbations and crises were not different, but decremental trends were shown in both groups after the thymectomies. (4) Conclusions: The daily dosage requirements of MG treatment drugs were not different. There was a trend of decreasing adverse event rates despite no statistically significant differences during the first 5 years after thymectomy in ThMG and non-ThMG patients.

摘要

(1) 背景:所有临床确诊的重症肌无力(MG)患者都建议进行早期胸腺切除术。然而,MG 患者胸腺切除术后的短期临床反应在文献中描述有限。本研究旨在比较胸腺瘤(Th)和非胸腺瘤(non-Th)MG 患者胸腺切除术后 5 年的结果。

(2) 方法:回顾性分析 2002 年至 2020 年在宋卡王子大学医院接受胸骨正中胸腺切除术且组织病理报告的年龄≥18 岁的 MG 患者。研究 ThMG 和 non-Th MG 患者的基线人口统计学和临床特征差异。我们比较了两组患者在胸腺切除术后 5 年内维持日常生活活动和收入所需的吡啶斯的明、泼尼松龙或硫唑嘌呤的日平均剂量(TWAs)。随访术后临床状态、加重或危象。采用描述性统计进行分析,以 < 0.05 为统计学意义。

(3) 结果:ThMG 患者的发病年龄更大,从 MG 诊断到胸腺切除术的时间更短。男性是唯一与 ThMG 相关的显著因素。两组患者每日 MG 治疗药物剂量的 TWAs 无差异。此外,两组的加重和危象发生率无差异,但两组在手术后均显示出递减趋势。

(4) 结论:MG 治疗药物的每日剂量需求没有差异。尽管在胸腺切除术后的前 5 年内,两组的不良事件发生率没有统计学差异,但仍有下降的趋势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44f0/9959777/a84225914a24/ijerph-20-03039-g001a.jpg

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