Antonini G, Morino S, Gragnani F, Fiorelli M
Department of Neurological Sciences, University of Rome La Sapienza, Italy.
Acta Neurol Scand. 1996 Apr;93(4):260-2. doi: 10.1111/j.1600-0404.1996.tb00517.x.
To evaluate clinical characteristics and outcome of myasthenia gravis (MG) in aged patients (> 60yrs), we retrospectively reviewed a continuous series of 122 myasthenic patients observed from January 1968 through December 1994. Patients with congenital, neonatal, or penicillamine-induced myasthenia were excluded. Twenty-five subjects (20%) were > 60yrs. The male/female ratio was 3:2; 20% of patients had an ocular form and 86% were seropositive. Mediastinum CT scan revealed thymic changes in 14%. During the first five years of disease, 60% of patients with ocular form progressed towards a generalized form and 15% had clinical relapses. At the time of their last visit, 40% of patients were asymptomatic and 60% had improved on medication. No patient died because of myasthenia-related causes. This study shows that MG in aged patients is characterized by prevalence in males, low frequency of ocular forms, low frequency of positive mediastinum CT which suggests low frequency of thymomas, high frequency of progression of ocular forms, and good response to corticosteroid therapy.
为评估老年患者(>60岁)重症肌无力(MG)的临床特征及转归,我们回顾性分析了1968年1月至1994年12月期间连续观察的122例肌无力患者。排除先天性、新生儿或青霉胺诱导性肌无力患者。25例受试者(20%)年龄>60岁。男女比例为3:2;20%的患者为眼肌型,86%血清学阳性。纵隔CT扫描显示14%有胸腺改变。在疾病的前五年,60%的眼肌型患者进展为全身型,15%有临床复发。在最后一次就诊时,40%的患者无症状,60%经药物治疗后病情改善。无患者因重症肌无力相关原因死亡。本研究表明,老年患者重症肌无力的特点是男性患病率高、眼肌型频率低、纵隔CT阳性频率低(提示胸腺瘤频率低)、眼肌型进展频率高以及对皮质类固醇治疗反应良好。