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目的提高对重症肌无力的认识和早期诊断水平。方法回顾分析以呼吸衰竭为首症的重症肌无力患者3例,1例误诊为病毒性脑炎;1例误诊为慢性阻塞性肺病急性发作;1例误诊为猝死。结果 3例患者接受有创机械通气但脱机困难,血清乙酰胆碱受体抗体增高,应用溴吡斯的明后成功脱机。结论在有慢性疾病基础上合并重症肌无力并出现肌无力危象时容易误诊。当II型呼衰患者难以脱机且不能用其他原因解释时,应考虑到重症肌无力的诊断并作证实。
Objective To improve the understanding and early diagnosis of myasthenia gravis. Methods Three cases of myasthenia gravis with respiratory failure were retrospectively analyzed. One case was misdiagnosed as viral encephalitis. One case was misdiagnosed as acute exacerbation of chronic obstructive pulmonary disease. One case was misdiagnosed as sudden death. Results Three patients underwent invasive mechanical ventilation but had difficulty in taking off the machine. Serum acetylcholine receptor antibody was elevated. Bromide was taken offline successfully in the future. Conclusions It is easy to misdiagnosis when combined with myasthenia gravis and myasthenic crisis on the basis of chronic diseases. When patients with type II respiratory failure are difficult to take offline and can not explain for other reasons, the diagnosis of myasthenia gravis should be taken into account and confirmed.