老年重症肌无力住院患者48例临床特点分析  

The clinical characteristic study of myasthenia gravis in 48 elderly inpatients

作　　者：钱云[1] 程曦[1] 马玉苹[1] 陈伟贤[1] 曾彦英[1] 

机构地区：[1]南京医科大学第一附属医院老年医学科,210029

出　　处：《临床神经病学杂志》2014年第6期425-428,共4页Journal of Clinical Neurology

摘　　要：目的分析老年重症肌无力（MG）住院患者的有关临床特点。方法回顾性分析近年来在我院住院诊治的48例老年MG患者的临床资料。结果老年MG患者占总住院MG病例数（175例）的比例为27.4%。男性多于女性,男∶女=2.7∶1。老年MG多在60~69岁之间发病,在其常见首发症状中,眼部症状最多,为34例（70.8%）、球麻痹其次,为8例（16.7%）、肢体肌无力5例（10.4%）、肌萎缩1例（2.1%）。老年MG患者中,全身型比例（70.8%）显著高于眼肌型（29.2%）,较少合并自身免疫性疾病和发生危象,常合并胸腺病变（17例）及其他内外科疾病（36例）,其中15例为胸腺瘤。伴胸腺病变的老年MG患者出现首发症状的年龄与无胸腺病变的老年MG患者比较差异无统计学意义;而伴胸腺病变的老年MG患者需住院治疗时的年龄显著小于无胸腺病变的老年MG患者,差异有统计学意义（P〈0.05）。结论老年MG具有其自身特点,男性多见,早期表现多为眼肌无力,全身型比例高于眼肌型,胸腺病变主要为胸腺瘤,危象发生率较低等临床特点。Objective To investigate the clinical features of myasthenia gravis （MG） in elderly inpatients. Methods The clinical data of 48 elderly inpatients with MG observed in recent years were analyzed retrospectively. Results Of the 175 MG inpatients, 48 （27.4%） patients were identified with the onset of the disease at or after the age of 60, and the number of males were more than females with the ratio of 2.7： 1. Most elderly inpatients with MG found between 60 and 69. Among commom initial symptoms, the ocular synptoms were the most, in 34 cases （70.8） %. Bulbar paralysis symptoms were the following symptoms, in 8 cases（ 16.7% ）. The third symptoms were the weakness of the limbs, in 5 cases （ 10.4% ）. Only one patient（2.1% ） manifested muscle atrophy. The systemic form（70.8% ） was significantly more often than ocular form （29.2%）. There were less elderly inpatients with MG accompanied with autoimmunity diseases and developing crisis. It was commom in elderly MG inpatients accompanied with abnormal thymus（ 17 cases） and followed by other medical complication（36 cases）. In addition, there were 15 cases of thymoma. There was no difference of age-of-onset between elderly MG inpatients with abnormal thymus and those without abnormal thymus. The age of the elderly MG patients with abnormal thymus should be administered to hospitalization was much less than the others without abnormal thymus （P 〈 0.05 ）. Conclusions MG in elderly has its own specific clinical features. The prevalence of MG in elderly is increasing in males. The initial symptom in the majority of cases was ocular fatigue. The systemic form is significantly more than ocular form. Abnormality of thymoma is mainly, and the occurrence rate of crisis is lower.

关 键 词：重症肌无力 胸腺瘤 老年人 临床特点 

分 类 号：R746.1[医药卫生—神经病学与精神病学]