重症肌无力181例眼部情况分析  

An analysis of ocular conditions in 181 patients with myasthenia gravis

作　　者：王静波[1] 谢应勤[1] 王慧霞[1] 张桥[1] 关娟[1] 余欢龙[1] 

机构地区：[1]解放军第三0九医院眼科,北京100091

出　　处：《中华眼视光学与视觉科学杂志》2012年第11期698-699,共2页Chinese Journal Of Optometry Ophthalmology And Visual Science

基　　金：基金项目：国家自然科学基金（81100684）

摘　　要：目的总结并分析我院重症肌无力（MG）患者的眼部情况。方法回顾性病例研究。对2009年1月至2011年8月来我科会诊的181例MG患者行眼科检查，包括视力、裂隙灯显微镜检查、眼底、屈光状态、33cm及6m眼位、眼球运动、红玻片法检查复视像，部分患者行同视机检查。对数据进行分类、整理和归纳。结果181例中，眼肌型MG占多数（86例，47．5％）；眼位正常者150例（82．9％）；上睑下垂175例（96．7％）；单眼弱视5例（2．8％）；复视156例（86.2％）。单条眼外肌麻痹55例（30．4％），多条眼外肌麻痹77例（42．5％）。全眼外肌麻痹13例（7．2％）。55例单条眼外肌麻痹患者中，内直肌受累最多（14例，25．5％）。结论MG患者中眼肌型占了近半数，绝大多数均有上睑下垂和复视，但绝大多数患者的眼位都是正常的。部分患者因发病较早，上睑下垂造成了形觉剥夺性弱视。MG患者的眼外肌麻痹可为单条、多条或全眼外肌麻痹，其中多条和单条眼外肌麻痹多见。在单条眼外肌麻痹的患者中，内直肌受累更多见。Objective To summarize and analyze the ocular conditions of patients with myasthenia gravis （MG） diagnosed in the MG therapy center and those who came for ocular consultation in our department. Methods In a retrospective case study, 181 patients with MG who came for ocular consultation from January 2009 to August 2011 were analyzed, and underwent the following examinations ： visual acuity, slit lamp microscope examination, fundus examination, refractive condition, eye alignment at 33 cm and 6 m, eye movement, and diplopic images by the red glass test. Some patients were also examined with a synoptophore. Data was categorized, collected and analyzed. Results Of those 181 cases, many patients were diagnosed with ocular MG （86, 47.5%）, 150 cases had normal eye alignment （82.9%）, 175 cases had eyelid ptosis （96.7%）, 5 cases had monocular amblyopia （2.8%）, and 156 patients had diplopia （86.2%）. Of those 181 cases, 55 patients （30.4%） had paralysis of one simple ocular muscle, 77 cases （42.5%） had paralysis of muhiple ocular muscles, and 13 patients （7.2%） had paralysis of all ocular muscles. Of those 55 patients with paralysis of one simple ocular muscle, most had involvement of the medial rectus （14, 25.5%）. Conclusion Almost half of the former patients with MG who came for ocular consultation were diagnosed with ocular MG. In patients with MG, most had eyelid ptosis and diplopia. However, most patients had normal eye alignment. The patients who developed MG early had form deprivation amblyopia because of eyelid ptosis. Paralysis of ocular muscles can involve one simple muscle, multiple muscles or all muscles, and most patients had a paralysis of multiple muscles or one simple muscle. In patients with paralysis of one simple ocular muscle, the medial rectus muscle was most often involved.

关 键 词：重症肌无力 眼 肌肉 

分 类 号：R746.1[医药卫生—神经病学与精神病学]