重症肌无力52例临床特征并文献复习

Myasthenia gravis:a clinical analysis of 52 cases and literature review

目的探讨重症肌无力(MG)的临床特征和诊断要点。方法回顾性分析徐州医科大学附属医院神经内科2015年1月一2018年7月收治的52例MG患者的临床资料。结果本组患者主要临床表现为眼睑下垂、复视、声音嘶哑或吞咽困难、四肢无力,少见呼吸费力.新斯的明试验阳性率100%(52/52),重复神经电刺激阳性率为90.7%(39/43),胸腺CT检查阳性率52.0%(26/50),甲状腺功能异常阳性率28.9%(13/45),男性异常率10.5%(2/19),女性异常率42.3%(11/26):结论MG女性较多发,多以眼肌症状首发,Ⅰ型和Ⅱ B型较为常见、新斯的明试验和重复电刺激阳性率较高,女性常伴有胸腺、甲状腺功能异常,自身抗体检测有助于指导合理诊疗及评估预后。

Objective To investigate the clinical features and diagnosis of myasthenia gravis(MG).Methods The cdinical data of 52 patients with MG admitted in the Department of Neurology,the Affiliated Hospital of Xuzhou Medical University from January 2015 to July 2018 were retrospectively analyzed.Results The main clinical manifestations were blepharoptosis,diplopia,hoarseness or dysphagia,limb weakness and rarely dyspnea.The positive rate of neostigmine test was 100%(52/52).The positive rate of repetitive nerve stimulation was 90.7%(39/43).The positive rate of thymus CT examination was 52%(26/50).The positive rate of abnormal thyroid function was 28.9%(13/45),of which 10.5%(2/19)in males and 42.3%(11/26)in females.Conclusions MG is more common in women,mostly with ocular muscle symptom as first symptom.TypesⅠandⅡB are more common.The positive rates of neostigmine test and repetitive electrical stimulation are higher.Women are often accompanied with thymus and thyroid dysfunction.The detection of autoantibodies is helpful to guide rational diagnosis and treatment and to evaluate prognosis.