胸腺扩大切除术治疗重症肌无力的远期疗效

Long-term Effectiveness of Extended Thymectomy in the Treatment of Myasthenia Gravis

目的评价胸腺扩大切除术术后重症肌无力(myasthenia gravis,MG)的远期疗效及预后的影响因素。方法回顾性分析2005年1月至2010年12月我院共施行胸腺扩大切除术治疗重症肌无力45例患者的临床资料,其中男11例、女34例,年龄32.6(16~50)岁。对所有患者进行随访,计算有效率,了解疗效随时间的变化,并对患者性别、年龄、Osserman分型、病理类型进行单因素分析。结果 45例完成随访,随访率100%,随访时间58.3(36~108)个月。有效率80.0%(36/45),随访时间越长有效率越高。影响重症肌无力疗效的单因素分析表明,性别(P=0.666)不是MG预后的影响因素,而年龄(P=0.019)、Osserman分型(P=0.024)和病理类型(P=0.043)是预后的影响因素。结论胸腺扩大切除术远期疗效满意,且随访时间越长预后更好。

Objective To assess the long-term efficacy of extended thymectomy in the treatment of myasthenia gravis(MG) and the factors influencing the results. Methods We retrospectively analyzed the clinical data of 45 MG patients who underwent extended thymectomy in our hospital from January 2005 through December 2010. There were 11 males and 34 females at age of 32.6(16-50) years. The overall effective rate was calculated. Univariate analysis was used to analyze the risk factors including sex,age,Osserman classification,and pathological type for outcomes. Results All the patients were followed up for a mean of 58.3 months(ranged from 36 to 108 months). The overall effective rate was 80.0%(36/45) and rose with the extention of time. Age(P=0.019),pathological type(P=0.024) of thymus and Osserman classification(P=0.043) of MG were the main factors influencing the outcomes of the treatment except sex(P=0.666). Conclusion Extended thymectomy in the treatment of MG has better outcomes. And the overall effective rate rises with the extention of time.