摘要
目的 研究伴有胸腺瘤的重症肌无力 (MG)患者的治疗方法和影响预后的因素。方法回顾性研究 10 3例经手术证实的MG伴胸腺瘤患者。给予皮质类固醇、化学疗法、放射疗法等治疗 ,观察患者的远期疗效和生存率。结果 MG总有效率为 78 6 % ,其中完全缓解 2 3例 (2 2 3% )、药物缓解 2 6例 (2 5 2 % )、部分缓解 32例 (31 1% )。 5年和 10年生存率分别为 77 8%和 48 5 % ,其中淋巴细胞为主型分别为 88 9%和 72 7% ,混合型为 83 3%和 5 8 3% ,上皮细胞为主型为 5 5 6 %和 10 0 % ;按Masaoka分期标准 ,Ⅰ期和Ⅱ期患者的 5、10年生存率分别为 89 8%和 76 2 % ,Ⅲ期和Ⅳ期为 35 7%和0 %。皮质类固醇和放疗等综合治疗患者 5年和 10年生存率分别达到 88 9%和 5 7 1%。结论 MG伴胸腺瘤患者手术后应给予皮质类固醇、放疗和化疗等综合治疗 ,以提高疗效和患者生存率。上皮细胞型胸腺瘤和Masaoka分期Ⅲ期和Ⅳ期患者预后较差。
Objective To investigate the treatments and prognostic factors of myasthenia gravis (MG) accompanied with thymomas and evaluate the treatment effects of such cases. Methods Our study was based on 103 cases of MG with surgically proved thymoma treated in our hospital The patients were treated with steroid therapy, radiotherapy and chemotherapy We evaluated the long term effects, the survival rate and the prognostic factors. Results The overall effective rate was 78 6%.Twenty three patients obtained a result of complete remission (22 3%), 26 pharmacological remission (25 2%), and 32 improvement (31 1%) The overall survival rates were 77 8% and 48 5% at 5 and 10 years, respectively Based on the three histologic types, the survival rates at 5 and 10 years of lymphyocytic thymoma were 88 9% and 72 7% respectively, of mixed thymoma 83 3% and 58 3%, of epithelial thymoma 55 6% and 10 0% The survival rates of stage Ⅰ and Ⅱ were 89 8% and 76 2% respectively at 5 and 10 years, and of stage Ⅲ and Ⅳ were 35 7% and 0% The survival rates of patients treated with steroid and radiotherapy were 88 9% and 57 1% respectively. Conclusions The administration of steroids therapy, radiotherapy and chemotherapy after removal of thymomas may enhance the long term curative effect in patients of MG with thymoma However, patients with epithelial thymoma or Masaoka's stage Ⅲ and Ⅳ had rather poor prognosis
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2001年第2期84-87,共4页
Chinese Journal of Neurology
关键词
重症肌无力
胸腺瘤
病理学
治疗
预后
Myasthenia gravis
Thymoma
Pathology
Therapy
Prognosis
