大剂量糖皮质激素冲击治疗对伴和不伴甲状腺功能亢进的重症肌无力患者疗效研究  

Curative efficacy observation of the high-dose glucocorticoid implosive therapy in MG patients with and without hyperthyroidism

作　　者：王雅璇 乞国艳 杨瑛 顾珊珊 李永召 WANG Yaxuan;QI Guoyan;YANG Ying;GU Shanshan;LI Yongzhao(Hebei Provincial Myasthenia Gravis Diagnosis and Treatment Center,Shijiazhuang People’s Hospital,Shijiazhuang 050030,China)

机构地区：[1]石家庄市人民医院河北省重症肌无力诊疗中心,石家庄050030

出　　处：《长春中医药大学学报》2022年第4期432-434,共3页Journal of Changchun University of Chinese Medicine

基　　金：河北省重点研发计划项目民生科技专项(19277701D);石家庄市科学技术研究与发展计划(181460483)。

摘　　要：目的观察大剂量糖皮质激素冲击治疗对伴和不伴甲状腺功能亢进的重症肌无力患者疗效。方法选取石家庄市人民医院重症肌无力诊疗中心MG数据库2013-2020年登记的1290例MG初诊病例,筛选出30例合并甲状腺功能亢进患者为观察组,30例甲状腺功能正常MG患者为对照组。予以大剂量糖皮质激素冲击治疗,比较2组胸腺异常、临床分型情况,治疗前ACHR-Ab比较,CSR率比较,以及影响预后的因素。结果观察组胸腺瘤发生率明显低于对照组(P<0.05);观察组重症肌无力临床分型Ⅰ型比对照组更为多见(P<0.05);观察组治疗前后ACHR-Ab水平明显低于对照组(P<0.05);2组治疗后ACHR-Ab水平均较治疗前下降(P<0.05);2组达CSR率比较,差异无统计学意义(P>0.05)。结论胸腺切除术联合大剂量激素冲击治疗对改善合并甲亢的重症肌无力患者的预后,提高临床疗效等有重要意义。Objective To observe the curative efficacy of the high-dose glucocorticoid implosive therapy in myasthenia gravis(MG)patients with and without hyperthyroidism.Methods From a total of 1,290 newly diagnosed MG cases registered in the MG database of the myasthenia gravis treatment center of the Shijiazhuang People’s Hospital from 2013 to 2020,30 MG patients with hyperthyroidism were selected as the observation group,while 30 MG patients with the normal thyroid function were selected as the control group.The two groups were both treated with the high-dose glucocorticoid implosive therapy,and their thymic abnormalities,clinical types,ACHR-Ab before treatment,CSR rates,and factors a□ecting prognosis were compared.Results The incidence of thymoma in the observation group was significantly lower than that in the control group(P<0.05).The clinical type I of myasthenia gravis in the observation group was more common than that in the control group(P<0.05).The ACHR-Ab level in the observation group was significantly lower than that in the control group before and after treatment(P<0.05).The ACHRAb levels in both groups after treatment were lower than those before treatment(P<0.05).There was no significant difference in the CSR rate between the two groups(P>0.05).Conclusion Thymectomy combined with the high-dose hormone implosive therapy is of great significance in improving the prognosis and clinical efficacy of myasthenia gravis patients complicated with hyperthyroidism.

关 键 词：大剂量糖皮质激素冲击治疗 甲状腺功能亢进 重症肌无力 疗效观察 

分 类 号：R746.1[医药卫生—神经病学与精神病学]