重症肌无力病情严重程度对尿动力学参数的影响

Effect of Myasthenia Gravis Degree on Urodynamic Parameters

目的探讨眼肌型(Ⅰ型)及全身型(Ⅱ型)重症肌无力(myasthenia gravis,MG)患者尿动力指标的差异,为临床治疗重症肌无力提供参考。方法分别检测8例眼肌型及15例全身型MG患者尿动力学指标,分析组间尿动力参数差异及组间各指标异常人数构成比差异。结果全身型MG患者最大尿流率显著低于眼肌型患者(P<0.05);全身型MG患者最大尿流率异常人数比率显著高于眼肌型患者(P<0.05),而膀胱收缩力增强人数显著低于眼肌型患者(P<0.05);全身型MG患者初始尿意、残余尿量异常比率及膀胱出口梗阻发生率均高于眼肌型患者,但差异无显著性(P>0.05);女性MG患者膀胱收缩增强人数显著高于男性(P<0.01)。结论全身型MG患者最大尿流率异常人数显著高于眼肌型,MG病情加重可能会伴发尿动力异常,临床诊疗应加以重视。

Objective To investigate the difference in urodynamic indexes between patients with ophthalmos(typeⅠ)and systemic(typeⅡ)myasthenia gravis(myasthenia gravis,MG),and to provide references for clinical treatment of myasthenia gravis.Methods The urodynamic indexes of 8 cases of ophthalmotype and 15 cases of systemic MG were detected respectively,and the differences in urodynamic parameters between the groups and the differences in the composition ratio of abnormal numbers of each index between the groups were analyzed.Results The maximum urinary flow rate of patients with systemic MG was significantly lower than that of patients with ophthalmos(P<0.05);the rate of abnormal maximum urine flow of patients with systemic MG was significantly higher than that of patients with ophthalmics(P<0.05),while the bladder contracted,the number of force-enhancing patients was significantly lower than that of ophthalmic patients(P<0.05);the initial urinary intention,residual urine volume abnormal rate and the incidence of bladder outlet obstruction in systemic MG patients were higher than those of ophthalmic patients,but the difference was not significant(P>0.05);the number of female MG patients with increased bladder contraction was significantly higher than that of males(P<0.01).Conclusion The number of patients with systemic MG with abnormal maximum urinary flow rate is significantly higher than that of ocular muscle type.The aggravation of MG may be accompanied by abnormal urodynamics,and clinical diagnosis and treatment should be paid attention to.