眼肌型重症肌无力的临床研究  

Clinical study on the ocular myasthenia gravis

作　　者：田燕[1] 魏世辉[2] 于生元[3] 

机构地区：[1]山东省单县中心医院眼科,274300 [2]解放军总医院眼科 [3]解放军总医院神经内科

出　　处：《中华眼底病杂志》2006年第6期379-381,共3页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的探讨眼肌型重症肌无力的临床特点及治疗。方法对1998年7月至2005年7月我院收治的84例眼肌型重症肌无力患者的临床表现、实验室检查、胸腺计算机断层扫描（CT）检查及治疗资料进行回顾性分析。结果本组患者发病年龄2．5～70岁。全部患者均有上睑下垂。其中35．7％伴有复视；25％伴有显性斜视。1例伴有眼内肌异常；1例出现视物模糊。血清AchR抗体检查阳性率27．6％，胸腺CT检查异常率64．3％。溴化吡啶斯的明（单纯3-二甲胺基甲酰氧基1甲基吡啶溴化物）口服治疗组治愈率48．1％；大剂量甲基强的松龙冲击治疗组治愈率66．7％；胸腺切除手术组治愈率51．9％。结论眼肌型重症肌无力患者以提上睑肌受累多见，也可有其它眼肌的受累；治疗应结合病情，可给予胆碱脂酶抑制剂、大剂量甲基强的松龙冲击及胸腺切除手术，治疗效果显著。Objective To observe the clinical manifestations and treatment of ocular myasthenia gravis. Methods The clinical manifestations, results of laboratory examination and thymic CT, and therapeutic data of 84 patients with ocular myasthenia gravis, hospitalized from July, 1998 to July, 2005, were retrospectively analyzed. Results These patients were 2.5 to 70 years old. All of the patients had ptosis, includine 35. 77% with diplopia 25% with strabismus; 1 with obnormal sphincter muscle and 1 with blurry vision. The positive rate of examination of AchR antibody was 27.6%, and abnormal rate of examination of thymic CT was 64.3%. The cure rate was 48. 1% in oral administration with tabellae in whomdostigmini group, 66. 7% in methylprednisolonum hormone therapy group, and 51. 9% in thymectomy group. Conclusions Ocular myasthenia gravis is mostly involved levator palpebrae superiors and sometimes also involved other ocular muscles. Anticholinesterase medication, methylprednisolonum hormone therapy or thymectomy are effective.

关 键 词：无力/治疗 胆碱脂酶抑制剂/治疗应用 激素类/治疗应用 胸腺切除术 

分 类 号：R746.1[医药卫生—神经病学与精神病学]