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目的 研究儿童重症肌无力 (MG)伴甲状腺功能亢进症 (甲亢 )的临床特点及治疗。方法 对88例儿童MG伴甲亢患者的临床资料和治疗方法进行回顾性研究 ,并与同时期成人MG伴甲亢患者进行比较。结果 男性 35例 ,女性 5 3例 ;就诊时MG患者Ⅰ型 72例 ,ⅡA型 8例 ,ⅡB型 6例 ,Ⅳ型 2例 ;先有甲亢后有MG18例 ,先有MG后有甲亢 34例 ,MG和甲亢同时发生 36例 ;合并癫痫 6例 ,伴胸腺增生 16例 ;经过治疗 6 0 .2 3%的患者痊愈 ,7.95 %的患者无效。结论 儿童与成年人MG合并甲亢患者在性别上发病无统计学差异 ,而临床类型分布不同 ,儿童组以Ⅰ型多见 ;两种疾病的发生顺序不同 ,儿童先发生甲亢者较少 ,成人组先发生甲亢者多见。儿童MG伴甲亢患者的临床表现复杂 ,诊断较难 ,容易误诊和漏诊 ,提高对本病的认识是改善预后的关键。
Objective To study the clinical features and treatment of children with myasthenia gravis (MG) and hyperthyroidism (hyperthyroidism). Methods The clinical data and treatment of 88 MG patients with hyperthyroidism were retrospectively studied and compared with those of patients with hyperthyroidism in the same period. Results There were 35 males and 53 females. There were 72 cases of type Ⅰ in MG, 8 cases of type ⅡA, 6 cases of type ⅡB and 2 cases of type Ⅳ in MG patients. There were 18 cases of MG after hyperthyroidism and 34 cases of hyperthyroidism after MG , MG and hyperthyroidism occurred simultaneously in 36 cases; 6 cases of epilepsy combined with thymus hyperplasia in 16 cases; after treatment 6.23% of the patients recovered, 7.95% of the patients were ineffective. Conclusion There is no significant difference in the incidence of gender between hyperthyroidism and MG in children and adults. However, the distribution of clinical types is different in children and adults with type Ⅰ. The order of occurrence of the two diseases is different. Children with hyperthyroidism first develop less. Hyperthyroidism occurred more common. Children with hyperthyroidism MG patients with complex clinical manifestations, the diagnosis is more difficult to misdiagnosis and missed diagnosis, improve the understanding of the disease is the key to improving prognosis.