环磷酰胺治疗93例重症肌无力伴胸腺瘤的疗效观察

发布时间：2019-03-06 08:39

【摘要】：目的探讨环磷酰胺对重症肌无力伴胸腺瘤患者的治疗效果。方法选择2010年1月—2015年12月湖州市中心医院和浙江大学附属第二医院神经内科被诊断为重症肌无力伴胸腺瘤患者93例作为研究对象,根据胸腺瘤的恶性程度将其分为较低恶性胸腺瘤组(44例)和较高恶性胸腺瘤组(49例)。2组患者均给予环磷酰胺静滴治疗。比较较低恶性胸腺瘤组和较高恶性胸腺瘤组的一般情况、治疗前后重症肌无力临床评分、治疗效果以及不良反应情况。结果 2组治疗前重症肌无力临床评分比较差异无统计学意义(P0.05),2组治疗后重症肌无力临床评分比较差异无统计学意义(P0.05);治疗后较低恶性胸腺瘤组的重症肌无力临床评分低于治疗前的重症肌无力临床评分,差异有统计学意义(P0.05),治疗后较高恶性胸腺瘤组的重症肌无力临床评分低于治疗前的重症肌无力临床评分,差异有统计学意义(P0.05),较低恶性胸腺瘤组和较高恶性胸腺瘤组的治疗有效率分别为88.6%和85.7%,2组比较差异无统计学意义(P0.05),较低恶性胸腺瘤组的白细胞降低、转氨酶升高、乏力、恶心、呕吐的不良反应和较高恶性胸腺瘤组之间比较差异无统计学意义(P0.05)。结论环磷酰胺治疗重症肌无力伴胸腺瘤是安全有效的,对较低恶性胸腺瘤和较高恶性胸腺瘤重症肌无力患者的治疗效果没有差异。
[Abstract]:Objective to evaluate the efficacy of cyclophosphamide in the treatment of myasthenia gravis with thymoma. Methods from January 2010 to December 2015, 93 patients with myasthenia gravis and thymoma were diagnosed as myasthenia gravis and thymoma in the Department of Neurology of Huzhou Central Hospital and the second affiliated Hospital of Zhejiang University. According to the malignant degree of thymoma, they were divided into lower malignant thymoma group (44 cases) and higher malignant thymoma group (49 cases). To compare the general situation of lower malignant thymoma group and higher malignant thymoma group, clinical score of myasthenia gravis before and after treatment, therapeutic effect and adverse reaction. Results there was no significant difference in clinical scores of myasthenia gravis between the two groups before treatment (P0.05), and there was no significant difference in clinical scores of myasthenia gravis between the two groups after treatment (P0.05). After treatment, the clinical score of myasthenia gravis in the lower malignant thymoma group was lower than that in the pre-treatment group, and the difference was statistically significant (P0.05). The clinical score of myasthenia gravis in the higher malignant thymoma group after treatment was lower than that in the pre-treatment group, and the difference was statistically significant (P0.05). The effective rates of treatment in lower malignant thymoma group and higher malignant thymoma group were 88.6% and 85.7%, respectively. There was no significant difference between the two groups (P0.05). The leukopenia and transaminase in lower malignant thymoma group were lower than those in high malignant thymoma group. There was no significant difference in the side effects of fatigue, nausea, vomiting and higher malignant thymoma between the two groups (P0.05). Conclusion Cyclophosphamide is safe and effective in the treatment of myasthenia gravis with thymoma. There is no difference in therapeutic effect between patients with lower malignant thymoma and higher malignant thymoma myasthenia gravis.
【作者单位】：湖州市中心医院神经内科;浙江大学附属第二医院神经内科;杭州市红十字会医院麻醉科;
【基金】：2015年浙江省医药卫生计划项目(2015KYA187)
【分类号】：R746.1;R736.3

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