胸腺病理在重症肌无力胸腺切除手术后远期预后生存分析中的作用  

The role of thymus pathology in long-term prognostic analysis of thymectomized patients with myasthenia gravis

作　　者：刘伟[1] 佟倜[1] 纪振东[1] 张振和[1] 

机构地区：[1]白求恩医科大学第一临床学院胸外科,长春130021

出　　处：《中国免疫学杂志》2001年第7期377-379,共3页Chinese Journal of Immunology

基　　金：吉林省卫生厅科研基金资助项目

摘　　要：目的 :探讨重症肌无力胸腺切除术后影响远期生存的因素。方法 :采用胸腺切除手术治疗 170例重症肌无力患者 ,对其中 12 4例进行了超过 40个月的远期随访 ,运用COX回归模型分析影响远期预后的有关因素 (包括胸腺的各病理类型、性别、年龄、病程、术前临床Osserman分型和治疗 )。同时运用免疫组织化学染色检测 36例胸腺石腊标本中的T细胞和B细胞的数量 ,并与远期预后做等级相关分析。结果 :重症肌无力胸腺切除术后不同的胸腺病理类型远期生存率有明显差异 ,表现为胸腺增生 >良性胸腺瘤 >胸腺萎缩 >恶性胸腺瘤 (P <0 0 5 ) ,胸腺中T细胞和B细胞的数量与术后的远期预后呈显著负相关 (P <0 0 5 )。结论 :胸腺不同的病理类型是影响重症肌无力胸腺切除术远期预后的重要因素 。Objective:To study the factors affecting the long term prognosis of patients with myasthenia gravis after thymectomy.Methods:170 MG patients were taken thymectomy,among them 124 patients were received long term follow up more than 40 months postoperatively,COX regression analysis model was used to analysis the factors (including thymic pathology,patient gender,age,duration of disease at the time of surgery,preoperative Osserman classiffication and medication).T lymphocyte and B lymphocyte of 36 cases in the thymus were examined using immuno histochemistry technique,the rank correlation analysis was also made among thymic T cells,B cells,and patients'prognosis.Results:The research showed that the survival rate were significantly different in the different pathological types after thymectomy,which showed hyperplasia>benign thymoma>atrophy>malignant thymona(P<0 05),and the percentage of T and B cells in the thymus were negatively interrelated to the prognosis significantly(P<0 05).Conclusion:The different thymic pathological types were the important factors affecting the long term survival in MG patients after thymectomy,and the thymic T and B cells were related to prognosis of MG patients.

关 键 词：重症肌无力 胸腺切除术 胸腺病理 预后 

分 类 号：R746.1[医药卫生—神经病学与精神病学] R392.3[医药卫生—临床医学]