合并胸腺瘤的重症肌无力临床研究  

Clinical study of the relation between thymoma and myasthenia gravis

作　　者：高政[1] 范洪玉 张东明[1] 聂志余[1] 王乃昌[1] 包礼平[1] 

机构地区：[1]大连医科大学附属第二医院神经内科,辽宁大连116027 [2]大连市第七人民医院

出　　处：《中风与神经疾病杂志》2001年第1期34-36,共3页Journal of Apoplexy and Nervous Diseases

摘　　要：目的 探讨胸腺瘤病理分型、病理分期和重症肌无力(MG)之间关系。方法 分析1986～1996年 88例经手术证实为胸腺瘤患者，其中28例术前合并MG，分析这28例患者胸腺瘤病理分型、病理分期与MG发生年龄、性别、Osserman临床分型及术后MG缓解加重关系特点。结果 发现胸腺瘤伴有MG28例(31.8%)；其中男18例占64.3%；女10例占35.7%；发病年龄以40～59岁为高峰期，共20例，占71.4%；病理分型证实上皮细胞型胸腺瘤MG发病率高，且临床症状重，以Osserman临床分型Ⅱa,Ⅱb型为主，肌无力危象发生率高，死亡率高；其次为上皮淋巴细胞混合型胸腺瘤。上皮细胞型胸腺瘤术后MG症状缓解后再加重多于混合型胸腺瘤。症状加重多见于术后3～12个月。28例患者Masaoka病理分期I期8例，Ⅱ期10例，Ⅲ期10例；I期以Osserman临床分型I型为主，术后无MG症状缓解后再加重；Ⅱ、Ⅲ期以Ⅱa、Ⅱb型为主，术后MG症状缓解后再加重比率高。结论 胸腺瘤伴MG患者以男性多见，发病年龄以40～59岁为主，以上皮细胞型为主，Masaoka病理分期为Ⅱ、Ⅲ期胸腺瘤MG临床症状重，且术后MG症状缓解后易再加重。Objective To study relationship between Mas aoka pathological stage and type of thymoma and myasthenia gravis. Methods To analyse pathological sections and clinical manifestations of 88 cases who had received thymectomy from 1986 to 1996. Among the 88 cases, 28 cases were MG. The pathological stage and type, age, sex and Osserman typ e were analysed between thymoma and MG. Results 28 cases with the thymoma complicated by MG is presented (31.8%) including male 18 and female 10 cases. 2 0 ca ses from 40～59 years old patients were at peak periods (71.4%). The incidence of epithelial cell type thymoma complicated by MG has raised and its clinical symptom was serious. The e pithelial cell type was relied on Osserman type Ⅱa and Ⅱb.The incidence and death rate of MG crisis has raised. 28 cases of thymoma were accompanied with MG and Masaoka pathological stage. The first ,second and third stages were 8, 10, and 10 cases respectively ; 1st stage was relied ma inly on Osserman type I, 2nd and 3rd stages were relied mainly on Osserman type Ⅱa and Ⅱb. Conclusion Thymoma complicated by MG relies mainly on mal e and on epithelial cell type . Masaoka pathological stager also relies on Ⅱ, and Ⅲ , and clinical symptom is serious.

关 键 词：胸腺瘤 重症肌无力 Osserman临床分型 MG危象 并发症 

分 类 号：R746.106[医药卫生—神经病学与精神病学] R736.3[医药卫生—临床医学]