重症肌无力的临床和胸腺病理分析(附173例报告)

The clinical and pathologic analysis of 173 cases myasthenia gravis after thymectomy

目的研究重症肌无力患者胸腺的病理改变、临床分型和分期的临床意义。方法回顾性分析173例行胸腺切除重症肌无力患者的术后病理所见与临床特点。结果173例胸腺组织表现为胸腺增生88例(50.87%),胸腺瘤79例(45.66%),正常胸腺4例(2.31%),胸腺萎缩2例(1.16%);胸腺增生组14例(15.91%)、胸腺瘤16例(20.25%)出现术后肌无力危象;重症肌无力患者Osserman临床分型、Masaoka临床病理分期、病理类型间有一定的相关性;多数重症肌无力患者有一种或多种免疫学指标异常。结论综合分析重症肌无力患者的临床资料,结合免疫学的检测结果,有助于该病的有效防治。

Objective To investigate the pathological changes of thymus for myasthenia gravis,as well as the significance of clinical staging and classification. Methods Pathologic change and clinical symptoms of 173 cases of postthymectomy were retrospectively analyzed. Results Among the 173 cases of thymusectomy, 88 cases had thymic hyperplasia, there were 79 cases thymoma,4 cases of normal thymus and 2 cases of atrophy of thymus gland; 14 cases had mysthenic crisis after thymectomy among the group of thymic hyperplasia. 16 cases had mysthenic crisis after thymectomy for the thymoma.There was some associativity among pathologic categories, Masaoka clinical staging and Osserman clinical types; Most patients had one or many kinds of abnormal indicatrix of immunology. Conclusions For the patients of myasthenia gravis,Biding the immunological results and aggregating analysis of the three documents, myasthenia gravis possibly been effectively prevented and cured.