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目的总结中国北方地区60岁以后发病的老年重症肌无力(MG)患者的临床特点。方法回顾性总结47例老年MG患者的性别构成、首发症状、病情严重程度、胸腺改变、伴发疾病、治疗情况、发生危象比例等,并与中青年MG患者进行比较。结果老年MG患者占所有住院MG患者的23.04%,男女比例为0.96:1.00;老年MG患者以上睑下垂为主要首发症状,病情最重时约68.09%的患者进展为全身型MG,这一比例低于中青年组(P<0.05);该组老年MG患者合并胸腺瘤的比例为22.5%,低于中青年组(P<0.05);59.57%的患者合并糖尿病、原发性高血压、冠心病等内科疾病,高于中青年组(P<0.05);除应用溴吡斯的明治疗以外,72.34%的患者应用了免疫抑制剂治疗,仅19.15%的患者应用激素治疗,应用激素治疗的比例低于中青年组(P<0.05);1 2.76%的老年MG患者出现肌无力危象,与中青年组比较差异无统计学意义。结论老年MG患者并不少见,男女比例相近,以上睑下垂为最常见首发症状,病情最重时大多数患者会发展为全身型MG,故仍需要给予免疫调节治疗;老年MG患者合并胸腺瘤比例低于中青年患者,但合并其他内科疾病比例高于中青年患者,其治疗以免疫抑制剂为主,而激素应用和胸腺切除术受到限制。
Objective To summarize the clinical features of elderly patients with myasthenia gravis (MG) who have developed from the age of 60 in northern China. Methods A retrospective review of 47 elderly MG patients with gender composition, the first symptom, the severity of the disease, thymus changes, associated disease, treatment, the proportion of crisis occurred, and with young and middle-aged patients with MG were compared. Results The elderly patients with MG accounted for 23.04% of all hospitalized patients with MG, the ratio of male to female was 0.96: 1.00. Patients with senile MG had ptosis as the main initial symptom. The most serious condition was 68.09% of patients progressed to systemic MG. (P <0.05). The proportion of elderly patients with MG with thymoma was 22.5%, lower than that of middle-aged and young patients (P <0.05). 59.57% patients with diabetes mellitus, essential hypertension, coronary heart disease (P0.05) .In addition to the treatment with triamcinolone acetonide, 72.34% of the patients were treated with immunosuppressive drugs, only 19.15% of the patients were treated with hormone therapy, the proportion of hormone therapy (P <0.05). 1. 2.76% of MG patients with myasthenia gravis appeared crisis of myasthenia gravis, compared with the young group there was no significant difference. Conclusion Elderly patients with MG are not uncommon, the proportion of men and women are similar, with the most common ptosis is the most common initial symptom, the most serious condition when most patients will develop into systemic MG, it is still necessary to give immunomodulatory treatment; elderly patients with MG thymoma ratio Lower than younger patients, but the proportion of other medical diseases combined with the higher proportion of young patients, the treatment of immunosuppressive agents, and hormone application and thymectomy limited.