Olanow C W, Lane R J, Roses A D
Arch Neurol. 1982 Feb;39(2):82-3. doi: 10.1001/archneur.1982.00510140016004.
Between 1977 and 1979, 12 consecutive patients with myasthenia gravis who were over the age of 55 years were treated by thymectomy. In all, their conditions improved clinically; 11 of the 12 became free of the generalized features of myasthenia gravis. Nine patients required no further medication. Acetylcholine-receptor antibody titers did not change significantly. Although five patients had atrophic thymus glands, their conditions also improved. We conclude that (1) thymectomy is a safe and effective therapy for patients with myasthenia gravis who are over the age of 55 years; (2) steroids and anticholinesterase agents are not essential in the management of late-onset myasthenia gravis; and (3) reduction in acetylcholine-receptor antibody titer is not essential for beneficial clinical response.
1977年至1979年间，对12例年龄超过55岁的重症肌无力患者连续进行了胸腺切除术治疗。总体而言，他们的病情在临床上有所改善；12例中有11例不再有重症肌无力的全身症状。9例患者无需进一步药物治疗。乙酰胆碱受体抗体滴度无明显变化。尽管5例患者胸腺萎缩，但病情也有所改善。我们得出结论：（1）胸腺切除术对于年龄超过55岁的重症肌无力患者是一种安全有效的治疗方法；（2）类固醇和抗胆碱酯酶药物在迟发性重症肌无力的治疗中并非必需；（3）乙酰胆碱受体抗体滴度降低对于临床有益反应并非必需。
