胸腺切除治療眼肌型重癥肌無(wú)力療效及影響因素分析.pdf

1、福建醫(yī)科大學(xué)碩士學(xué)位論文胸腺切除治療眼肌型重癥肌無(wú)力療效及影響因素分析姓名：黃玉章申請(qǐng)學(xué)位級(jí)別：碩士專業(yè)：神經(jīng)病學(xué)指導(dǎo)教師：王檸20100401ABSTRACTThymectomyinthetreatmentofocularmyastheniagravisandrelevantinfluencingfactorsobjective：Toevaluatetheefficacyofthymectomyaccesstherelevantinf

2、luencingfactorsforthetreatmentofocularmyastheniagravisMethods：Weconductareviewandfollow—upofall63patientswhohaddiagnosedOMGandreceivedtreatmentbetweenJanuary2003andDecember2009attheneurologydepartmentofTheFirstAffiliated

3、HospitalofFujianMedicalUniversityPatients’responsetotreatmentwascategorizedasfollows：Effectiveorineffective，converrttogeneralizedmyastheniagravisorremainpurelyocularweaknessTherateofefficiencybetweenthymectomygroupandnon

4、surgicaltreatmentgroupWascomparedbyChi—squaretestandtherateofconversionbetweentwogroupswascomparedbyKaplanMeieranalysisAnanalysisWasstudiedincomparisonofthymectomyage，gender’oralprednisone，chestCT；accompanyautoimmunedise

5、asesandoralimmunosuppressivedrugswithCoxregressionanalysismodelResults：26caseshadreceivedthymectomy2caseslost；non—surgicaltreatmentof37patients，4caseslost57casfeswerefollowedupforamediandurationof36months(range2360months

6、，interquartilerange99months)Histologicalthymicabnormalitieswerefoundin885％ofthethymectomygroupTherateofconversionWaslowerinthethymectomygroupthannon—surgicalgroup(Log—Rank，P005)TheCOXregressionmodelrevealsthattherateofco

7、nversionWasstatisticallyindependentofthymectomyandchestCTConclusion：HistologicalthymicabnormalitieswerecommoninOMGThymectomyisasafetreatmentforOMGitCanpreventtheprogressionofOMGtoGMGbutitdosenotsignificantlyimprovethesym