目的 探讨眼肌型重症肌无力进展为全身型重症肌无力的临床相关预测因素。方法 33例初诊为眼肌型重症肌无力的患者经过3年随访,根据疾病进展结局分为眼肌型重症肌无力组（13例）和进展为全身型重症肌无力组（20例）。对与疾病进展可能相关的临床因素进行分析。结果 进展为全身型重症肌无力组患者初诊时的定量重症肌无力评分、乙酰胆碱受体抗体阳性率、抗核抗体阳性率、合并胸腺瘤的比例以及合并糖尿病的比例均高于眼肌型重症肌无力组（P值均<0.05）。结论 定量重症肌无力评分高、乙酰胆碱受体抗体阳性、抗核抗体阳性以及合并胸腺瘤和糖尿病可能是眼肌型重症肌无力进展为全身型重症肌无力的预测指标。
Abstract
Objective: To evaluate the predictors for ocular myasthenia gravis (OMG) conversing to secondary generalized myasthenia gravis (GMG). Methods: Thirty-three patients initially diagnosed of OMG were followed-up for three years to observe the progression of the disease. According to the outcomes at the end of the follow-up, the patients were divided into two groups: OMG group (n = 13, maintaining OMG) and GMG group (n = 20, conversing to GMG). The clinical characteristics and laboratory findings were compared between the two groups. Results: The quantitative myasthenia gravis score (QMGS), positive rates of anti-acetylcholine receptor antibody (AChRAb) and antinuclear antibody and the incidence rates of accompanying with thymoma and diabetes of GMG group were all significantly higher than those of the OMG group (all P < 0.05). Conclusion: This study suggests that higher QMGS, positive expressions of AChRAb and antinuclear antibody and accompanying with thymoma and diabetes may be used as the predictors for the poor outcomes of OMG conversing to GMG.
关键词
重症肌无力 /
眼肌型 /
重症肌无力 /
全身型 /
预后 /
预测因素
Key words
Myasthenia gravis, ocular /
Myasthenia gravis, generalized /
Prognosis /
Predictive factors
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