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目的 观察晚发型 (≥ 5 0岁 )重症肌无力 (MG)的临床特点及治疗。方法 5 3例 MG患者 ,其中晚发型 2 9例 (5 4.7% ) ,2 9例均做 EMG、Ach R- Ab、胸腺 CT及 X线检查 ;分别给予皮质激素药物、大剂量免疫球蛋白(IVIG)和新斯的明类药物治疗。 2 9例中男性 16例 ,女性 13例 ,平均年龄 6 4.4(5 0～ 83)岁。结果 分型以轻型为多 ,占 75 .8% ,无胸腺瘤证据 ,Ach R- Ab阳性率 36 .3%。三组治疗以 IVIG+新斯的明组疗效好 (P<0 .0 1) ,激素治疗组不良反应大。结论 晚发型 MG发病在增加 ,此型胸腺瘤少见 ,以新斯的明 +IVIG治疗效果好 ,并发症少。
Objective To observe the clinical features and treatment of late-onset (≥50 years) myasthenia gravis (MG). METHODS: Twenty-three patients with MG were enrolled in this study. Among them, 29 cases were late-onset (57.4%) and 29 cases were performed EMG, Ach R-Ab, CT and X-ray examination of thymus. Patients with MG were given corticosteroids and high-dose immunoglobulin IVIG) and neostigmine treatment. There were 16 males and 13 females in 29 cases, with an average age of 6 4.4 (range, 50-83) years. The results were classified as mild, accounting for 75.8%, no evidence of thymoma, Ach R-Ab positive rate of 36.3%. Three groups of treatment with IVIG + neostigmine group effect (P <0.01), hormonal treatment group adverse reactions. Conclusions The onset of late-onset MG is increasing. This type of thymoma is rare. Neostigmine + IVIG is effective and has fewer complications.