期刊
ACTA NEUROLOGICA SCANDINAVICA
卷 143, 期 1, 页码 96-102出版社
WILEY
DOI: 10.1111/ane.13332
关键词
myasthenia gravis; predictors; prognosis; related factor; thymoma
资金
- Project of Guangzhou Science Technology and Innovation Commission [201707010122]
- Guangdong natural science foundation Committee [2017A030313829, 2018A030313449]
- National Key R&D Program of China [2017YFC0907700]
- Southern China International Cooperation Base for Early Intervention and Functional Rehabilitation of Neurological Diseases [2015B050501003]
- Guangdong Provincial Engineering Center For Major Neurological Disease Treatment
- Guangdong Provincial Translational Medicine Innovation Platform for Diagnosis and Treatment of Major Neurological Disease
- Guangdong Provincial Clinical Research Center for Neurological Diseases
Thymomatous myasthenia gravis (T-MG) differs clinically from non-thymomatous myasthenia gravis (NT-MG), with thymoma considered a risk factor for MG. Preoperative use of anticholinesterase drugs is a protective factor for the long-term prognosis of T-MG. Understanding the characteristics of T-MG may help improve its prognosis.
Objectives To summarize the clinical features of thymomatous myasthenia gravis (T-MG), examine the association between MG and thymoma, and identify the related factors or predictors for long-term prognosis of T-MG. Methods A retrospective, observational study was conducted on 100 patients with T-MG and 96 patients with non-T-MG (NT-MG) between January 1, 2009 and December 31, 2019. The baseline characteristics were recorded for each patient. Logistic regression was used to measure the association between all clinical variables and T-MG prognosis. Results Between the T-MG and NT-MG groups, age at onset (45.66 +/- 11.53 years vs 39.06 +/- 14.39 years); age >40 years (72.0% vs. 40.6%); AChR-Ab positive rate (100.0% vs. 83.3%); Myasthenia Gravis Foundation of America (MGFA) classification at the worst condition (>= grade III, 61.0% vs. 33.0%); thyroid dysfunction (7.0% vs. 20.8%); and outcome (complete stable remission + pharmacologic remission + improvement, 74.0% vs. 93.7%) were statistically significant (P < .05). Presence of thymoma (OR = 0.196, 95%CI = 0.076-0.511,P = .001) was a risk factor for MG. Male sex, post-operative complications, higher grade of MGFA classification, and thymoma Masaoka-Koga pathological stage were risk predictors for long-term prognosis of T-MG (P < .1). Use of preoperative anticholinesterase drugs (OR = 5.504, 95%CI = 1.424-21.284,P = .013) was identified as an independent predictor for T-MG. Conclusion T-MG is clinically different from NT-MG, and thymoma is considered a risk factor for MG. Preoperative anticholinesterase drug use is a protective factor for long-term prognosis of T-MG. A comprehensive understanding of the characteristics of T-MG will likely help improve its prognosis.
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