重症肌无力病人胸腺切除术后血清自身抗体水平变化和临床转归分析

Analyses of clinical outcome and changes in serum auto-antibidies in Patients with myasthenia gravis after thymectomy

６９例重症肌无力（ＭＧ）病人行胸腺切除术，术前血清乙酰胆碱受体抗体水平均高于正常，术后半年抗体水平明显下降，胸腺增生组（２０例）尤为显著．胸腺瘤组（４９例）术前胸腺瘤相关抗体水平增高，但术后半年内无明显变化．６９例ＭＧ患者胸腺切除术后４年，症状总缓解率为７６．８１％，其中胸腺增生组９５％，胸腺瘤组６９．３９％。作者认为，对于伴有胸腺增生或胸腺瘤的ＭＧ患者，胸腺切除术是有效的，应该列为治疗的第一选择。

Sixty-nine patients with myasthenia gravis(MG) were divided into 2 groups, thywic hyperplasia and thymoma groups, according to the pathological findingS of thymus. All the patients were. followed up for 4 years after thymectomy, whose sera were detected for acetylcholine receptor antibody(AchRab) and thymoma-associated antibody (CAEab) at regular intervals. The resultS showed that AchRab titers significantly declined in 69 MG patients, particularly in 20 patients With thymic hyperplasia, half a year after thymectomy, but without any change in CAEab. At endpoint, the cumulative remission rate of 69 MG patients underwent thymectomy was 76.81%, with 95% in thymic hyperplasia group, and 69.39% in thymoma one. It is concluded that thymectomy should be a primary therapy in MG patients with thwic hyperplasia or thylnoma.