胸腺切除术并类固醇疗法治疗伴胸腺瘤的重症肌无力的远期疗效观察

The Long term Outcome of Thymectomy Combined with Steroid Therapy for 52 Myasthenia Gravis Patients Associated with Thymoma

目的评价胸腺切除术并皮质类固醇疗法对伴胸腺瘤的重症肌无力患者的远期疗效。方法对采用胸腺切除术并类固醇疗法治疗的５２例伴胸腺瘤的重症肌无力患者作回顾性研究，经术后１～２０年，平均（４．５±３．６）年的长期随访，评价其远期有效率和存活率。结果远期有效率为８８．５％（４６／５２），病死率１１．５％（６／５２）。在４６例远期存活者中，８例获完全缓解（１５．４％），２９例获药物缓解（５５．８％），９例明显改善（１７．３％）。５年存活率８６．４％，１０年存活率３３．３％。结论本研究结果提示胸腺切除术并皮质类固醇疗法治疗伴胸腺瘤的重症肌无力患者的远期疗效良好，该疗法对降低术后病死率和提高缓解率有重要作用。

Objective To evaluate the long term outcome of thymectomy combined with corticosteroid therapy for myasthenia gravis (MG) with thymoma. Methods Fifty two MG Patients with thymoma treated with thymectomy combined with corticosteroid therapy underwent a retrospective study during a follow up period of 1 to 20 years (mean4 5±3 6years) after thymectomy in order to evalute the long term effective rate and survival rate. Results The long term effective rate was 88 5% (46/52),mortality was 11 5%(6/52).In 46 survivors,8 of them obtained complete remission (15 4%),29 of them pharmacological remission (55 8%),9 of them marked improvement (17 3%).The overall 5 year survival rate was 86 4%,the overall 10 year survival rate was 33 3%. Conclusions The long term therapeutic results of thymectomy combined corticosteroid therapy were good for MG patients with thymoma.This therapeutic measure played an important role in decreasing mortality and increasing remission rate.