重症肌无力协会临床分型及定量评分的应用体会

目的探讨美国重症肌无力协会(MGFA)临床分型及定量评分(QMG)的临床意义。方法对2001年11月至2003年3月手术治疗的重症肌无力病人36例，分别按Osserman分型与MGFA分型并作比较，以探讨手术治疗前后OMG定量评分的变化，及与临床分型、近期疗效的关系。结果。MGFA临床分型中的Ⅰ型与Osserman Ⅰ型相同，Osserman Ⅱa型与Ⅱb型分别包含不同的MGFA临床类型；治疗后QMG评分随时间呈明显降低；不同疗效病人其QMG有显著差异，与Osserman疗效评分相一致。结论美国重症肌无力协会临床分型较Osserman分型更为细致、客观，其定量评分准确反映出治疗前后病情的变化，值得在临床上推广应用，以加强对重症肌无力的临床研究与协作。

Clinical significance of MGFA clinical classification and QMG

Objective: To explore the clinical significance of the new classification and quantitative MG (QMG) score published by myasthenia gravis foundation of America (MGFA). Methods: From Nov. 2001 to Mar. 2003, 36 MG patients were classified both with Osserman classification and MGFA clinical classification, the differences between the two classifications were analyzed. The QMG score was also studied before and after thymectomy, as well as its relationship with MGFA classification and therapy-outcome. Results: MGFA type I had the same meaning with Osserman type I, and the patients, assigned to be Osserman type Ia to type IIb were classified into 6 degrees from MGFA type IIa to type IVb, according to QMG examination. The QMG score changed with thymectomy and the time of follow-up, and was correlated with the therapy-outcome. Conclusion: MGFA clinical classification associated with QMG examination is more objective and precise than Osserman classification, and the individual QMG score is accordant with and reflect the outcome after thymectomy. Both MGFA clinical classification and QMG should be widely used in clinical works for deepening the study.