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目的探讨重症肌无力患者(MG)术后发生肌无力危象(MC)的危险因素,为早期预防和诊断MC提供依据。方法采用病例对照研究方法,将确诊的198例MG患者术后依据是否发生MC分为病例组和对照组,采用单因素和多因素logistic回归分析MC发病的危险因素。结果 MC的发病率为16.2%;多因素logistic回归分析结果显示,肌无力发生的危险因素有5个:胸腺瘤(OR=3.658)、Osseman分型(OR=2.570)、肌无力发生史(OR=4.212)、术前MC(OR=4.998)及抗胆碱酯酶药物不足(OR=2.641)。结论 MG患者术后发生MC的发病率较高,影响MC发病的独立危险因素较多且机制复杂,应针对这些高危因素进行早预防和诊断。
Objective To investigate the risk factors of postoperative myasthenic crisis (MC) in patients with myasthenia gravis (MG), and to provide a basis for early prevention and diagnosis of MC. Methods A case-control study was conducted in 198 cases of MG patients diagnosed according to whether they were divided into case group and control group. Univariate and multivariate logistic regression analysis was used to analyze the risk factors of MC. Results The incidence of MC was 16.2%. Multivariate logistic regression analysis showed that there were 5 risk factors for myasthenia gravis (OR = 3.658), Osseman classification (OR = 2.570), history of myasthenia gravis = 4.212), preoperative MC (OR = 4.998) and anticholinesterase drugs (OR = 2.641). Conclusion The incidence of MC in patients with MG is higher than that in patients with MG. There are many independent risk factors and complicated mechanisms that affect the pathogenesis of MC. Early prevention and diagnosis of these high risk factors should be carried out.