中国输血杂志2025，Vol.38Issue(9)：1188-1194,7.DOI:10.13303/j.cjbt.issn.1004-549x.2025.09.011
血浆置换治疗胸腺瘤相关重症肌无力的疗效分析
Efficacy analysis of plasma exchange treatment for thymoma-associated myasthenia gravis
洪苗 1钟嫦 2蔡东东 3魏彩辉 2胡兵 2肖昆 2阮芳鸣 2胡飘萍 2乐爱平 2张长林2
作者信息
- 1. 南昌大学第一附属医院 输血医学科,江西 南昌 330006||南昌大学公共卫生学院,江西 南昌 330006
- 2. 南昌大学第一附属医院 输血医学科,江西 南昌 330006
- 3. 南昌大学第二临床医学院,江西 南昌 330006
- 折叠
摘要
Abstract
Objective To evaluate the efficacy and safety of plasma exchange(PE)in thymoma-associated myasthenia gravis(MG),thereby to provide theoretical support for its application in the treatment of thymoma-associated MG.Meth-ods A total of 133 patients with thymoma-associated MG admitted from January 2018 to September 2024 were retrospective-ly analyzed.Patients were matched using propensity score to reduce selection bias,yielding 22 matched pairs for both PE group(n=22)and non-PE group(n=22).Patient characteristics including gender,age of disease onset,course of dis-ease,history of thymoma resection,clinical absolute scores[clinical absolute scores(CAS)and clinical relative scores(CRS)],and synchronized immunotherapy regimen of the two groups were analyzed.The CAS scores before and after treat-ment were compared between the two groups,and the CRS was used to assess the treatment efficiency.Safety of the two treatment regimens were also compared.Continuous variables were compared using the t-test or ANOVA,while categorical data were compared by the chi-square test.Results A total of 133 patients were included and divided into two groups ac-cording to whether they underwent plasma exchange treatment:the PE group(n=22)and the non-PE group(n=111).To exclude bias caused by large difference in the number of cases between the two groups,we performed propensity score matc-hing.After matching,the number of cases in both groups was 22.There was no significant difference in baseline clinical characteristics between the two groups(P＞0.05),including gender,age of onset,duration of disease course,history of thymectomy and baseline CAS score before treatment.Compared to the non-PE group,patients in the PE group showed more significant improvement in CAS score(5.09±1.95 vs 3.59±1.50,P＜0.05)and a higher CRS score(75.00%vs 50.00%,P＜0.001).Compared to the non-PE group,PE group had significantly longer ICU stay,longer hospital stay and higher hospitalization cost(P＜0.05).There was no statistically significant difference in adverse events between the two groups during treatment(P＞0.05).During long-term follow-up,both the PE and non-PE groups showed relatively low 1-,3-,and 5-year recurrence rate,with no significant difference between the two groups(P＞0.05).Conclusion This study indicates that plasma exchange has clear value in the treatment of patients with thymoma-associated myasthenia gravis.It can not only significantly improve patients' muscle strength to alleviate motor dysfunction and enhance quality of life,but also does not significantly increase the incidence of adverse reactions.Therefore,it can be regarded as one of the preferred treat-ment options that achieve a"balance between efficacy and safety"for such patients,and provides an important basis for op-timizing treatment strategies,improving prognosis,and promoting the application of subsequent treatment regimens.关键词
血浆置换/重症肌无力/胸腺瘤/疗效分析Key words
plasma exchange(PE)/myasthenia gravis(MG)/thymoma/efficacy analysis分类
医药卫生引用本文复制引用
洪苗,钟嫦,蔡东东,魏彩辉,胡兵,肖昆,阮芳鸣,胡飘萍,乐爱平,张长林..血浆置换治疗胸腺瘤相关重症肌无力的疗效分析[J].中国输血杂志,2025,38(9):1188-1194,7.
