重症肌无力的诊断与治疗

Diagnosis and treatment of myasthenia gravis

重症肌无力主要是由乙酰胆碱受体抗体介导的获得性神经肌肉接头传递障碍的自身免疫性疾病,临床表现为全身骨骼肌收缩无力。疾病早期眼外肌受累可出现眼睑下垂、复视等症状,易被误诊为眼科疾病,当出现咽喉肌、四肢肌无力时更需与多种疾病鉴别,临床存在一定程度的漏诊、误诊。文中概述了重症肌无力的流行病学、病因及发病机制、临床表现、分型、辅助检查、诊断及鉴别诊断、治疗进展等内容,供临床及神经专科医生参考。

Myasthenia gravis(MG)is mainly acetylcholine receptor antibody-mediated acquired autoimmune disease that affects the postsynaptic membrane at the neuromuscular junction.The predominant manifestation is muscle weakness.Extraocular muscles are frequently affected in the early stage of disease with typical symptoms of intermittent drooping of the upper eyelid(ptosis)and double vision(diplopia),which is easy to be misdiagnosed as an ophthalmic disease.When the weakness of the face,bulbar,neck and limb muscles occur,it needs to be differentiated from a variety of diseases.Other clinical disorders can present in a similar fashion and may be mistakenly labeled as MG.This paper summarizes the epidemiology,etiology,pathogenesis,clinical manifestations,classification,auxiliary examination,diagnosis,differential diagnosis,and treatment progress of MG,which can be used as a reference for clinicians and neurologists.