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胸腺切除术治疗重症肌无力的疗效:21例患者的研究

Effectiveness of thymectomy in myasthenia gravis: A study of 21 patients.

作者信息

Corbaz Sofía, Savransky Andrea, Gaeto Nadia, Gallo Adolfo, Barrenechea Marcelo, Monges María Soledad

机构信息

Servicio de Neurología, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina.

Servicio de Neurología, Hospital de Pediatría Prof. Dr. Juan P. Garrahan, Buenos Aires, Argentina.

出版信息

Med Clin (Barc). 2025 Aug;165(2):106957. doi: 10.1016/j.medcli.2025.106957. Epub 2025 May 22.

Abstract

INTRODUCTION

Myasthenia gravis is part of a group of neuromuscular junction disorders. Thymectomy has been shown to be effective for its clinical control. The aim of this study was to assess the usefulness and safety of thymectomy in children with myasthenia gravis.

METHODS

An analytical, retrospective, longitudinal study was conducted by reviewing the medical records of 21 patients with myasthenia gravis who underwent thymectomy and were followed-up for one year post-surgery. The variables assessed included the Myasthenia Gravis Activities of Daily Living score, pyridostigmine dose, corticosteroid dose, and myasthenia gravis exacerbations immediately before and up to one year after the surgery.

RESULTS

The activities of daily living score significantly improved at 12 months (p=0.002). Crises decreased within 3 months post-surgery; this trend was maintained at 12 months (p=0.0003). However, the reductions in pyridostigmine (p=0.147) and corticosteroid therapy (p=0.11) at 12 months did not reach statistical significance.

CONCLUSIONS

Thymectomy showed benefits, including improved scores on the Myasthenia Gravis Activities of Daily Living Scale and a reduction in the frequency of myasthenia gravis exacerbations/crises. These findings show that thymectomy is a safe and valid option to consider for pediatric patients who have not responded to the first-line treatment.

摘要

引言

重症肌无力是神经肌肉接头疾病中的一部分。胸腺切除术已被证明对其临床控制有效。本研究的目的是评估胸腺切除术对重症肌无力患儿的有效性和安全性。

方法

通过回顾21例接受胸腺切除术并在术后随访一年的重症肌无力患者的病历,进行了一项分析性、回顾性、纵向研究。评估的变量包括重症肌无力日常生活活动评分、溴吡斯的明剂量、皮质类固醇剂量以及手术前直至术后一年的重症肌无力加重情况。

结果

12个月时日常生活活动评分显著改善(p = 0.002)。术后3个月内危象减少;这一趋势在12个月时得以维持(p = 0.0003)。然而,12个月时溴吡斯的明(p = 0.147)和皮质类固醇治疗(p = 0.11)的减少未达到统计学意义。

结论

胸腺切除术显示出益处,包括重症肌无力日常生活活动量表评分的改善以及重症肌无力加重/危象频率的降低。这些发现表明,对于一线治疗无反应的儿科患者,胸腺切除术是一个值得考虑的安全有效的选择。

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