胸腺瘤合并重症肌无力患者术后预后影响因素分析

Influencing factors of the postoperative prognosis of patients with thymoma complicated with myasthenia gravis

目的探索影响胸腺瘤合并重症肌无力患者预后的危险因素。方法纳入163例胸腺瘤合并重症肌无力患者,所有患者均行胸腺切除术,收集患者住院期间的临床资料,采用单因素与多因素Logistic回归分析,分析影响影响术后预后的危险因素。结果单因素分析显示年龄(t=2.784,P=0.020)、Osserman分型(χ~2=7.369,P=0.018)、术前病程(Z=4.550,P=0.001)和Masaoka分期(χ~2=12.413,P<0.01)为影响患者的预后因素;多因素Logistic回归分析显示,Osserman分型(RR=2.675,95%CI:1.243~5.678,P=0.021)、术前病程(RR=1.173,95%CI:1.067~1.487,P=0.001)和年龄(RR=1.719,95%CI:1.164~3.082,P=0.023)为影响胸腺瘤合并重症肌无力患者术后预后的独立危险因素。结论 Osserman分型、术前病程和年龄为影响术后预后的独立危险因素。

Objective To investigate the risk factors of the postoperative prognosis in patients with thymoma complicated with myasthenia gravis. Methods One-hundred-and-sixty-three patients of thymoma complicated with myasthenia gravis were enrolled. All patients underwent thymectomy. Clinical information was collected for these patients,and risk factors influencing postoperative prognosis were examined by univariate and Logistic multivariate regression analysis. Results Univariate analysis suggested age（ t = 2. 784,P = 0. 020）,Osserman classification（ χ^2= 7. 369,P = 0. 018）,preoperative course of the disease（ Z = 4. 550,P = 0. 01）,and Masaoka classification（ χ^2= 12. 413,P〈 0. 01） as factors influencing the patient prognosis. Moreover,multivariate Logistic regression analysis showed that Osserman classification（ RR = 2. 675,95%CI： 1. 243-5. 678,P = 0. 021）,preoperative course of the disease（ RR = 1. 173,95% CI： 1. 067-1. 487,P = 0. 001）,and age（ RR = 1. 719,95% CI： 1. 164-3. 082,P = 0. 023） were independent risk factors of the postoperative prognosis in patients with thymoma and myasthenia gravis. Conclusion Osserman classification,preoperative course of the disease and age are independent risk factors of the postoperative prognosis in patients with thymoma complicated with myasthenia gravis.