临床结果在ACHR阳性一般化肌痛严重症:一个回顾性观察性研究
Pawan T Ojha1, Abhijeet M Gaikwad1, Rakesh Singh1
1Department of Neurology, Grant Government Medical College and Sir J. J. Hospital, Mumbai, Maharashtra, India.
Annals of Indian Academy of Neurology
|November 16, 2023
概括
在乙胆受体 (AChR) 抗体阳性泛性肌痛性肌痛症 (MG) 中,晚发症和修复药治疗与缓解相关. 胸腺切除术也改善了结果,即使在非胸腺瘤患者中也是如此.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 自免疫性疾病 自免疫性疾病
背景情况:
- 骨髓灰质炎 (MG) 是一种影响神经肌肉结合的自身免疫性疾病.
- 超过80%的通用MG病例涉及对尼古丁乙胆受体 (AChR) 的抗体.
- 尽管有治疗方法,但MG患者经常经历疾病波动,复发和缓解.
研究的目的:
- 为了研究具有 AChR 抗体的一般性MG 患者的临床形状.
- 为了确定治疗结果的预测因子在ACHR阳性泛化MG.
- 分析影响缓解,危机和恶化的因素.
主要方法:
- 对108名ACHR阳性泛型MG患者进行了回顾性,单中心的观察性研究.
- 收集了关于人口统计,临床表现,治疗和反应的数据,平均随访时间为33.75个月.
- 临床结果根据缓解类型,危机和恶化情况进行评估.
主要成果:
- 眼睛或眼球的症状是常见的初始表现,在第一年内进展到普遍的MG.
- 三分之一 (33.3%) 的患者在发病9.4个月内经历了肌危机.
- 晚期发病的MG (50-70岁) 和rituximab治疗与更好的缓解率 (OR分别为4.7和4.56) 相关.
- 菌酸莫菲提尔 (MMF) 与复发的增加有关 (OR 1.8).
- 在耐药病例中,与常规免疫抑制疗法 (IST) 相比,利图西马布的缓解率更高.
- 胸腺瘤患者的胸腺切除术 (32%的队列) 与非胸腺切除术的胸腺瘤患者相比,显著改善了缓解率 (55.6%与23.5%相比).
结论:
- 近三分之一的ACHR阳性通用MG患者面临肌危机,尽管得到了最佳的护理.
- 利图西马布在耐火性MG和胸膜切除术后失败病例中表现出有效性.
- 胸膜切除术与胸膜瘤和非胸膜瘤患者的改善结果有关.
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