摘要
目的分析重症肌无力(MG)合并自身免疫病的种类、发病年龄和临床特点。方法回顾性分析作者医院2008-01-2012-01住院的MG患者,包括合并自身免疫病的MG患者的临床资料、影像学及实验室检查资料及治疗记录。结果共收集MG患者305例,合并自身免疫病1种或1种以上者28例(9.18%),其中男9例、女19例,性别构成与非合并免疫病者无统计学差异(P>0.05)。自身免疫病在MG之前发病者12例,平均(69.6±35.3)个月;在MG发病之后者14例,平均(72.4±38.4)个月;与MG同时发现2例;(1)MG合并自身免疫病组的MG发病年龄为(33.9±9.4)岁,与非合并自身免疫病患者的MG发病年龄〔(35.3±12.2)岁〕无统计学差异(P>0.05)。合并甲状腺功能亢进(甲亢)患者MG发病年龄(27.4±12.5)岁,较合并其他自身免疫病患者的MG发病年龄〔(41.6±10.3)岁〕和非合并自身免疫病患者(35.3±12.2岁)均低(均P<0.05)。(2)合并的自身免疫病中属甲亢最多(13例),其次为类风湿性关节炎(5例)、桥本甲状腺炎(4例)、吉兰-巴雷综合征(3例)。其中有3例合并2种自身免疫病,1例合并3种自身免疫病。(3)合并自身免疫病MG患者的Osserman分型:发病初期Ⅰ型13例,Ⅱa型3例,Ⅱb型10例,Ⅲ型2例;其中MG合并甲亢患者以Ⅰ型发病10例,超过合并其他自身免疫病MG患者(P<0.05)。结论 MG可合并多种神经系统或全身自身免疫病,以甲亢最多见。合并甲亢的MG患者中MG发病年龄较轻,以眼肌型多见。自身免疫病可在MG发病前、后或同时期出现。
Objective To investigate the coincidence and clinical features of associated autoimmune diseases in patients with myasthenia gravis. Methods All case records had been collected from admitted MG patients including those with associated autoimmune diseases from 2008 01 to 2012-01, Their clinical data, imaging studies and laboratory examination results were retrospectively analyzed. Results Three hundred and five patients were included. One or more autoimmune diseases were diagnosed in 28 patients （9.18%）, who were 9 Males and 19 females, there were no sex ratio difference compared with the non-autoimmune diseases group （P 〉0.05）. Twelve patients developed autoimmune diseases 69.6 ± 35.3 months before MG symptoms onset. Fourteen patients developed autoimmune diseases 72.4 ± 38.4 months after MG symptoms onset, 2 patients simultaneously. （1） The mean onset age of MG symptoms in autoimmune diseases group was 33.9±9.4 years, which have no difference with non-autoimnmne diseases group （35.3 ±12.2 years, P〉0.05）. The mean onset age in MG associated hyperthyroidism was 27.4 ± 12.5 years, which was younger than other autoimmune diseases group （41.6± 10.3 years, P〈0.05） and non-autoimmune diseases group （35.3±12.2 years, P〈 0.05）. （2） Hyperthyroidism was most frequently found in autoimmune diseases group （13 patients）, rheumatoid arthritis was found in 5 patients, Hashimoto＇s thyroiditis in 4 patients, Guillain-Barre syndrome in 3 patients. Two autoimmune diseases were diagnosed together in 3 MG patients, and three in one MG patient. （3） Osserman classification in autoimmune diseases group： Thirteen cases were diagnosed as type I, 3 cases as type Ⅱ a, 10 eases as type Ⅱ b, 2 cases as type Ⅲ. Cases of Type I were more frequently diagnosed in MG group complicated with hyperthyroidism than other autoimmune diseases group （P〈0.05）. Conclusions One or more autoimmune diseases developed in MG patients, which could develop before or after MG onset, among whichhyperthyroidism was most frequently diagnosed. The onset age of MG symptoms in patients complicated hyperthyroidism was younger than other groups. Ocular type was more frequently found in this group.
出处
《中国神经免疫学和神经病学杂志》
CAS
北大核心
2012年第6期433-435,共3页
Chinese Journal of Neuroimmunology and Neurology
关键词
重症肌无力
自身免疫病
myasthenia gravis
autoimmune diseases
hyperthyroidism
