伴自主神经功能障碍的重症肌无力(附6例报告)

目的 探讨重症肌无力(MG)患者伴发自主神经功能障碍的病理生理机制。方法 在1172例MG中对合并手足血管舒缩功能和皮肤营养障碍伴阳萎和瞳孔不等的6例患者进行肌电图、头部和胸腺MR检查,给予免疫抑制剂和胆碱酯酶抑制剂等药物治疗,并随访。结果 6例患者头颅MR检查正常,肌电图重复电刺激见波幅衰减现象,单纤维肌电图阳性,2例胸腺MR示胸腺增生。在治疗后自主神经症状随肌无力症状改善而好转。结论MG患者的自主神经功能障碍可能与乙酰胆碱受体抗体侵犯平滑肌和交感神经有关。

Myasthenia gravis combined with dysfunction of autonomic nerve:a report of six cases

Objective To investigate the mechanism of dysfunction of autonomic nerve in myasthenia gravis (MG) . Methods 6 patients with MG with vasomotorial dysfunction of hand and feet and impotence, and anisocoria were checked by Elec-tromyogram (EMG) and MR of head and thymus, and observed before and after treatment with anticholinesterase drugs respectively , and then followed up. Results The 6 cases of EMG were decrement and Jitter positive, the heads MR were normal and thy-muses MR were hyperplasia in 2 cases. The 6 patients' symptoms and signs disappeared after treatment, with anticholinesterase drugs. Conclusions It is related dysfunction of autonomic to the antibodies of acetylcholine receptor which involve on smooth muscle and sympathetic nerve in MG patients.