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目的探讨重症肌无力患者胸腺切除术后影响远期预后的因素。方法对1988年5月至2002年5月155例行胸腺切除术治疗的重症肌无力患者进行长期随访,对可能影响预后的年龄、性别、术前病程、临床分型、病理类型等因素在术后2年内、2～5年、5年后三个间期进行二元Logistic回归模型分析。结果术后2年内熏临床分型、术前病程和病理类型3个因素与远期预后相关穴P<0.01雪;术后2～5年,术前病程和病理类型与远期预后相关穴P<0.01雪;而术后5年后,仅病理类型与预后相关穴P<0.01雪。结论临床分型、术后病程和病理类型3个因素在重症肌无力胸腺切除术后不同阶段不同程度地影响远期预后,强调早期手术治疗和术后巩固治疗是提高远期预后的关键。
Objective To investigate the factors affecting the long-term prognosis of patients with myasthenia gravis after thymectomy. Methods From May 1988 to May 2002, 155 patients with myasthenia gravis underwent thymectomy were followed up for a long time. The factors influencing the prognosis such as age, sex, preoperative course, clinical classification and pathological type were analyzed retrospectively. After 2 years, 2 to 5 years, 5 years after the three interim Logistic regression model analysis. Results Within 2 years after operation, there were 3 factors related to long-term prognosis, such as smoking type, preoperative pathological type and pathological type, P <0.01 snow; 2 to 5 years after operation, the correlation between preoperative course and pathological type and long-term prognosis P <0.01 snow; and 5 years after surgery, only the pathological type and prognosis related points P <0.01 snow. Conclusion The clinical classification, postoperative pathology and pathological type of three factors in different stages of myasthenia gravis after thymectomy affect the long-term prognosis to varying degrees, emphasizing early surgery and postoperative consolidation treatment is to improve the long-term prognosis of the key.