Department of Cardiothoracic Surgery, Tianjin Medical University General Hospital, Tianjin, China.
Eur J Neurol. 2023 Jul;30(7):2012-2021. doi: 10.1111/ene.15807. Epub 2023 Apr 9.
This study investigated the postthymectomy outcomes and factors affecting the prognosis of thymomatous generalized myasthenia gravis (TGMG).
Clinical records of 86 patients with TGMG who underwent thymectomy at our institution between 2012 and 2020 were retrospectively reviewed. Predictors of complete stable remission (CSR) and exacerbation were analyzed using multivariate regression analysis.
A total of 16 patients achieved CSR, four achieved pharmacological remission, six exhibited deterioration, and eight died of myasthenia gravis (MG; mean follow-up = 75.1 months). Male sex (p = 0.049) and disease duration < 11.5 weeks before surgery (p = 0.003) were significant positive predictors of CSR. Onset age < 52.8 years and symptoms of ocular and limb muscle weakness had a higher CSR rate than onset age > 52.8 years (p = 0.056) and symptoms of bulbar muscles (p = 0.071). Female patients had a significant higher risk of exacerbation (p = 0.042).
Male sex and disease duration < 11.5 weeks were independent predictors of CSR in TGMG postthymectomy. Onset age < 52.8 years and ocular and limb muscle weakness at onset were associated with a higher probability of achieving CSR than onset age > 52.8 years and bulbar muscle weakness. Female sex was an independent predictor of MG symptom exacerbation in TGMG postthymectomy.
本研究旨在探讨胸腺瘤型全身性重症肌无力（TGMG）患者胸腺切除术后的结局和影响预后的因素。
回顾性分析了 2012 年至 2020 年期间在我院接受胸腺切除术的 86 例 TGMG 患者的临床资料。采用多变量回归分析方法分析了完全稳定缓解（CSR）和恶化的预测因素。
共有 16 例患者达到 CSR，4 例达到药物缓解，6 例病情恶化，8 例死于重症肌无力（MG；平均随访时间为 75.1 个月）。男性（p=0.049）和手术前病程<11.5 周（p=0.003）是 CSR 的显著阳性预测因素。发病年龄<52.8 岁和眼肌及肢体肌无力症状的 CSR 率高于发病年龄>52.8 岁（p=0.056）和球部肌肉症状（p=0.071）。女性患者恶化的风险显著更高（p=0.042）。
男性和手术前病程<11.5 周是 TGMG 胸腺切除术后 CSR 的独立预测因素。发病年龄<52.8 岁和发病时眼肌及肢体肌无力与发病年龄>52.8 岁和球部肌肉无力相比，更有可能达到 CSR。女性是 TGMG 胸腺切除术后 MG 症状恶化的独立预测因素。
