晚发型重症肌无力临床研究

目的探讨晚发型重症肌无力(Myasthenia gravis,MG)患者的临床特点。方法回顾性研究40例晚发型MG的临床特点并与早发型MG比较。结果晚发型MG患者男/女比例高于早发型MG,为1.22:1。晚发型MG的症状由眼肌受累演变至全身症状(占67.5%)显著高于早发型MG(占38.7%)。晚发型MG的肌无力程度较早发型MG肌无力程度严重,而且血清乙酰胆碱受体(acetylcholine receptor,AchR)抗体阳性率及抗体水平均显著低于早发型MG低,但Titin抗体阳性率及抗体水平却显著高于早发型MG。胆碱酯酶抑制剂对晚发型MG的疗效不如早发型MG。结论晚发型MG是一个免疫异质性的MG亚群,它的临床表现以及血清免疫学特点不同于早发型MG。

The clinical study of late-onset myasthenia gravis

Objective To study the clinical features of late-onset myasthenia gravis(MG).Methods We retrospectively studied the clinical features of 40 cases of late-onset MG subgroup and compared them with 31 cases of early-onset MG subgroup.Results The male:female ratio in late-onset MG group was 1.22:1.which was higher than that in early-onset MG group.Our studies suggested that the percentage of ocular myasthenia cases becoming generalized in late-onset MG subgroup was 67.5%,which was significantly higher than that in early-on- set MG subgroup(P<0.05).The muscle weakness of patients in late-onset MG group was more severe than that in early-onset MG group.The mean titers and the positive rate of anti-titin antibodies were significantly higher in late-onset MG group than those in early-onset MG subgroup,but the positive rate and mean titers of AchR anti- bodies in late-onset MG subgroup were lower than those in early-onset MG subgroup((P<0.05).Cholinesterase inhibitor therapy was more effective in early-onset MG subgroup than in late-onset MG subgroup.Conclusion Late-onset MG subgroup is a particular form of MG which is different from early-onset MG subgroup in clinical and immunological features.