重症肌无力胸腺切除术后远期预后的多因素分析

Multivariate survival analysis of long-term follow-up after thymectomy for myasthenia greavis

目的探讨重症肌无力患者胸腺切除术后影响远期预后的因素。方法对1988年5月至2002年5月155例行胸腺切除术治疗的重症肌无力患者进行长期随访,对可能影响预后的年龄、性别、术前病程、临床分型、病理类型等因素在术后2年内、2～5年、5年后三个间期进行二元Logistic回归模型分析。结果术后2年内熏临床分型、术前病程和病理类型3个因素与远期预后相关穴P<0.01雪;术后2～5年,术前病程和病理类型与远期预后相关穴P<0.01雪;而术后5年后,仅病理类型与预后相关穴P<0.01雪。结论临床分型、术后病程和病理类型3个因素在重症肌无力胸腺切除术后不同阶段不同程度地影响远期预后,强调早期手术治疗和术后巩固治疗是提高远期预后的关键。

Objective To investigate the factors associated with long-term survival in myasthenia gravis (MG) after thymectomy. Methods We retrospectively reviewed 155 cases of thymectomy performed at a single university hospital from 1988 to 2002. Logistic regression analysis model was used to analyze the association between factors (age, gender, disease history, Osserman classification and pathological types ) and prognosis at follow-up 0～2 years, 2～5 years and 5～10 years after thymectomy. Results Three factors (disease history, Osserman classification and pathological types) were associated with the long-term survival in the first 2 years of thymectomy. And during 2 to 5 years, the disease history and pathological types were related to long-term survival. After 5 years only pathological types was associate with survival. Conclusion Osserman classification, disease history and pathological type are associated with the prognosis of MG after thymectomy.