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作者报告一例重症肌无力(MG)患者,戒烟后皮肤搽抹尼古丁使病情加重。 男,48岁,患水平、垂直复视、双眼睑下垂和斜视近六个月,每日有所波动。查体:眼运动各方向受限,用新斯的明可改善,右尺神经重频电刺激波幅下降12％,血清乙酰胆硷受体抗体阴性。住院当月戒烟搽抹尼古丁[Nicotinell TTS,21mg/24h,(30cm~2),ciba—Geigy]。治疗第五日,双眼睑下垂、眼肌麻痹、肌无力症状加重,尤其在搽抹后一小时最严重。去除搽抹剂3小时内恢复正常。因八日内皆可观察到类似症状而停用尼古丁搽抹剂。
The authors report one patient with myasthenia gravis (MG) who smoked nicotine on the skin to exacerbate the condition. Male, 48 years old, suffering from horizontal diplopia, double eyelid ptosis and strabismus for nearly six months with daily fluctuations. Physical examination: Eye movement is restricted in all directions, with neostigmine can be improved, right foot ulnar electrical stimulation amplitude decreased 12%, serum acetylcholine receptor antibody negative. Smoking Nicotine [Nicotinell TTS, 21 mg / 24 h, (30 cm ~ 2), ciba-Geigy] was used to stop smoking during the month. Treatment on the fifth day, double eyelid ptosis, ophthalmoplegia, muscle weakness symptoms worse, especially in the wiping one hour after the most serious. Remove the putty within 3 hours to return to normal. Nicotine smear was discontinued due to similar symptoms observed within eight days.