{"title":"重症肌无力危象的危险因素：中国西南地区回顾性研究","authors":"Xue Lin, Hongxi Chen, Xiaofei Wang, Ziyan Shi, Rui Wang, Hongyu Zhou","doi":"10.1155/ijcp/9145129","DOIUrl":null,"url":null,"abstract":"<div>\n <p><b>Background:</b> Myasthenic crisis (MC) is a rare but potentially fatal complication that can significantly worsen the prognosis of patients with myasthenia gravis (MG). However, predicting the occurrence of MC remains challenging. Therefore, this study aimed to identify potential risk factors associated with MC.</p>\n <p><b>Methods:</b> A retrospective study was conducted using the MG Cohort Database at the West China Hospital of Sichuan University from January 2004 to August 2023. The multivariate Cox regression analysis was performed to determine the risk factors for MC.</p>\n <p><b>Results:</b> Among the 1150 patients with MG included in the final analysis, 128 (11.1%) experienced at least one episode of MC. Independent risk factors identified for MC included age (hazard ratio [HR]: 1.02, 95% confidence interval [CI]: 1.01–1.03, <i>p</i> < 0.001), quantitative MG (QMG) score (HR: 1.04, 95% CI: 1.01–1.07, <i>p</i> = 0.003), MG Foundation of America (MGFA) class at diagnosis (HR: 3.19, 95% CI: 2.38–4.28, <i>p</i> < 0.001), and the presence of thymoma (HR: 3.21, 95% CI: 2.13–4.85, <i>p</i> < 0.001). In contrast, generalized MG (<i>p</i> = 0.891) and the presence of antimuscle-specific tyrosine kinase (MuSK) antibodies (<i>p</i> = 0.107) did not significantly increase the risk of developing MC.</p>\n <p><b>Conclusion:</b> Age, disease severity as indicated by the QMG score and MGFA class at diagnosis, along with thymoma presence were identified as potential predictors for MC in patients diagnosed with MG.</p>\n </div>","PeriodicalId":13782,"journal":{"name":"International Journal of Clinical Practice","volume":"2025 1","pages":""},"PeriodicalIF":2.2000,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/9145129","citationCount":"0","resultStr":"{\"title\":\"Risk Factors for Myasthenic Crisis in Patients With Myasthenia Gravis: A Retrospective Study in Southwest China\",\"authors\":\"Xue Lin, Hongxi Chen, Xiaofei Wang, Ziyan Shi, Rui Wang, Hongyu Zhou\",\"doi\":\"10.1155/ijcp/9145129\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n <p><b>Background:</b> Myasthenic crisis (MC) is a rare but potentially fatal complication that can significantly worsen the prognosis of patients with myasthenia gravis (MG). However, predicting the occurrence of MC remains challenging. Therefore, this study aimed to identify potential risk factors associated with MC.</p>\\n <p><b>Methods:</b> A retrospective study was conducted using the MG Cohort Database at the West China Hospital of Sichuan University from January 2004 to August 2023. The multivariate Cox regression analysis was performed to determine the risk factors for MC.</p>\\n <p><b>Results:</b> Among the 1150 patients with MG included in the final analysis, 128 (11.1%) experienced at least one episode of MC. Independent risk factors identified for MC included age (hazard ratio [HR]: 1.02, 95% confidence interval [CI]: 1.01–1.03, <i>p</i> < 0.001), quantitative MG (QMG) score (HR: 1.04, 95% CI: 1.01–1.07, <i>p</i> = 0.003), MG Foundation of America (MGFA) class at diagnosis (HR: 3.19, 95% CI: 2.38–4.28, <i>p</i> < 0.001), and the presence of thymoma (HR: 3.21, 95% CI: 2.13–4.85, <i>p</i> < 0.001). In contrast, generalized MG (<i>p</i> = 0.891) and the presence of antimuscle-specific tyrosine kinase (MuSK) antibodies (<i>p</i> = 0.107) did not significantly increase the risk of developing MC.</p>\\n <p><b>Conclusion:</b> Age, disease severity as indicated by the QMG score and MGFA class at diagnosis, along with thymoma presence were identified as potential predictors for MC in patients diagnosed with MG.</p>\\n </div>\",\"PeriodicalId\":13782,\"journal\":{\"name\":\"International Journal of Clinical Practice\",\"volume\":\"2025 1\",\"pages\":\"\"},\"PeriodicalIF\":2.2000,\"publicationDate\":\"2025-02-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ijcp/9145129\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Clinical Practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1155/ijcp/9145129\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Clinical Practice","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1155/ijcp/9145129","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景：重症肌无力危象（MC）是一种罕见但潜在致命的并发症，可显著恶化重症肌无力（MG）患者的预后。然而，预测MC的发生仍然具有挑战性。因此，本研究旨在确定与MC相关的潜在危险因素。方法：使用四川大学华西医院2004年1月至2023年8月MG队列数据库进行回顾性研究。结果：纳入最终分析的1150例MG患者中，128例（11.1%）至少经历过一次MC发作。确定的MC独立危险因素包括年龄(风险比[HR]: 1.02, 95%可信区间[CI]: 1.01-1.03, p <；0.001)，定量MG （QMG）评分（HR: 1.04, 95% CI: 1.01-1.07, p = 0.003），诊断时美国MG基金会（MGFA）分级(HR: 3.19, 95% CI: 2.38-4.28, p <；0.001)，胸腺瘤的存在(HR: 3.21, 95% CI: 2.13-4.85, p <；0.001)。相比之下，广泛性MG （p = 0.891）和抗肌肉特异性酪氨酸激酶（MuSK）抗体的存在（p = 0.107）并没有显著增加发生MC的风险。结论：年龄、QMG评分和诊断时MGFA分级所显示的疾病严重程度以及胸腺瘤的存在被确定为MG患者MC的潜在预测因素。
Risk Factors for Myasthenic Crisis in Patients With Myasthenia Gravis: A Retrospective Study in Southwest China
Background: Myasthenic crisis (MC) is a rare but potentially fatal complication that can significantly worsen the prognosis of patients with myasthenia gravis (MG). However, predicting the occurrence of MC remains challenging. Therefore, this study aimed to identify potential risk factors associated with MC.
Methods: A retrospective study was conducted using the MG Cohort Database at the West China Hospital of Sichuan University from January 2004 to August 2023. The multivariate Cox regression analysis was performed to determine the risk factors for MC.
Results: Among the 1150 patients with MG included in the final analysis, 128 (11.1%) experienced at least one episode of MC. Independent risk factors identified for MC included age (hazard ratio [HR]: 1.02, 95% confidence interval [CI]: 1.01–1.03, p < 0.001), quantitative MG (QMG) score (HR: 1.04, 95% CI: 1.01–1.07, p = 0.003), MG Foundation of America (MGFA) class at diagnosis (HR: 3.19, 95% CI: 2.38–4.28, p < 0.001), and the presence of thymoma (HR: 3.21, 95% CI: 2.13–4.85, p < 0.001). In contrast, generalized MG (p = 0.891) and the presence of antimuscle-specific tyrosine kinase (MuSK) antibodies (p = 0.107) did not significantly increase the risk of developing MC.
Conclusion: Age, disease severity as indicated by the QMG score and MGFA class at diagnosis, along with thymoma presence were identified as potential predictors for MC in patients diagnosed with MG.
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