Nakamura H, Fukuda M, Suzuki Y, Taniguchi Y, Tanaka Y, Ishiguro K, Hara H, Mori T
Second Department of Surgery, Tottori University, Faculty of Medicine, Yonago, Japan.
Kyobu Geka. 1995 Mar;48(3):184-9.
Eighty-three patients with myasthenia gravis underwent thymectomy were reviewed to evaluate the long term effects of thymectomy and analyse the factors influencing outcome. Follow up times were from 3 months to 120 months (mean: 77.6 months) after operation. The effects of thymectomy were as follows: 1) Remission rate was 26.5%, improvement rate was 56.5% and palliation rate was 83.1% at the last observed time in all cases. 2) Remission rates showed increasing (7.3% at 1 year, 22.2% at 5 years, 35.3% at 10 years) according to the time courses. Improvement rates and palliation rates showed respectively maximum (78.3%, 94.4%) at 4 years and 5 years. 3) Analysis of factors influencing outcome showed that the cases of IIA in Osserman's classification, less than 40 years old in age, less than 12 months in duration of illness, no complication of thymoma were expected the better effectiveness of thymectomy. We concluded that thymectomy for myasthenia gravis expected the delayed remission according to the time courses, and so, we must carefully follow the patients for long time.
对83例行胸腺切除术的重症肌无力患者进行回顾性研究，以评估胸腺切除术的长期效果并分析影响预后的因素。术后随访时间为3个月至120个月（平均77.6个月）。胸腺切除术的效果如下：1）所有病例在最后一次观察时的缓解率为26.5%，改善率为56.5%，缓解率为83.1%。2）缓解率随时间推移呈上升趋势（1年时为7.3%，5年时为22.2%，10年时为35.3%）。改善率和缓解率分别在4年和5年时达到最高（78.3%，94.4%）。3）对影响预后因素的分析表明，Osserman分类中的IIA型病例、年龄小于40岁、病程小于12个月、无胸腺瘤并发症的患者，胸腺切除术的效果预期更好。我们得出结论，重症肌无力患者的胸腺切除术效果会随时间推移出现延迟缓解，因此，我们必须对患者进行长期密切随访。
