重症肌无力加重因素的临床分析

发布时间：2018-04-02 17:09

本文选题：重症肌无力　切入点：加重因素　出处：《宁夏医科大学》2017年硕士论文

【摘要】：目的分析影响重症肌无力病情加重的相关危险因素,为临床预防其病情加重、提高治疗效果及改善预后提供参考。方法收集宁夏医科大学总医院神经内科2005年1月-2016年3月的MG住院患者共117例,分析非住院条件下致病情加重并导致住院治疗的相关危险因素,得出MG非住院条件下病情加重的诱发因素。住院条件下,根据患者住院期间病情发展情况,将18例入院后病情加重患者分为病例组,99例入院后病情未加重患者分为对照组,收集病例组与对照组的一般病历资料、院前加重因素、合并胸腺瘤、其他自身免疫性疾病以及入院后使用糖皮质激素、血浆置换、喹诺酮类抗生素、氨基糖苷类抗生素、头孢类抗生素等药物治疗情况,比较两组间不同因素致病情变化不同的差异性。结果收集病例中男女不同性别发病年龄比较具有差异性(t=2.673,P=0.009),男女不同性别合并胸腺瘤比较具有差异性(χ2=6.022,P=0.014),男女不同性别合并其他自身免疫性疾病比较具有差异性(χ2=3.914,P=0.048)。MG病情加重的因素包括感染、过度劳累、自行停减药、手术、精神创伤、妊娠。住院条件下,病例组与对照组比较两组患者性别、年龄、民族,使用头孢类抗生素、血浆置换+大剂量GCs与单独使用大剂量GCs冲击治疗比较不具有差异性;病例组与对照组中使用大剂量GCs冲击治疗与未使用比较具有差异性(χ2=7.012,P=0.008);病例组与对照组中使用大剂量激素冲击治疗与使用小剂量激素递增治疗比较具有差异性(χ2=4.069,P=0.044)。结论1.MG病情加重的诱因可能包括感染、过度劳累、自行停减药、手术、精神创伤、妊娠;2.大剂量GCs冲击治疗可能短期加重MG病情3.PE可能不能预防大剂量GCs冲击治疗致使MG病情加重。
[Abstract]:Objective to analyze the risk factors related to the exacerbation of myasthenia gravis, and to provide reference for clinical prevention of exacerbation of myasthenia gravis, improvement of therapeutic effect and prognosis.Methods A total of 117 MG patients from January 2005 to March 2016 in Department of Neurology, General Hospital of Ningxia Medical University, were collected.The inducing factors of the aggravation of MG in non-hospital condition were obtained.Under the condition of hospitalization, according to the development of patients' condition during hospitalization, 18 patients with aggravated condition after admission were divided into two groups: the case group, 99 patients with no exacerbation after admission, and the general medical records of the case group and the control group were collected.Prehospital aggravation factors, combined thymoma, other autoimmune diseases, and use of glucocorticoids, plasma exchange, quinolones, aminoglycoside antibiotics, cephalosporins and other drugs after admission,To compare the difference between the two groups caused by different factors.Aggravating factors include infection,Overwork, self-withdrawal, surgery, trauma, pregnancy.There was no significant difference in sex, age, nationality, cephalosporal antibiotics, plasma exchange high dose GCs between the case group and the control group compared with the control group.There was a significant difference between the two groups (蠂 ~ 2 / 7.012) compared with those in the control group (蠂 ~ 2 / 7.012), and there was a significant difference between the two groups (蠂 ~ 2 / 4.069P ~ (0.044)) compared with that in the control group (蠂 ~ 2 / 4.069P ~ (0.044)), and there was a significant difference between the case group and the control group (P < 0.05).Conclusion the causes of exacerbation of 1.MG may include infection, overwork, withdrawal of drugs, surgery, trauma and pregnancy.High dose GCs shock therapy may aggravate MG condition in a short period of time 3.PE may not prevent MG from aggravating caused by high dose GCs shock therapy.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R746.1

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