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重症肌无力

最后审阅: 10 Nov 2024
最后更新: 13 Dec 2023

小结

定义

病史和体格检查

关键诊断因素

  • 肌力易疲劳
  • 睑下垂
  • 复视
  • 吞咽困难
  • 构音障碍
  • 面神经麻痹
  • 四肢近端无力
  • 呼吸短促
完整详情

危险因素

  • 自身免疫性疾病家族史
  • 遗传标记
  • 癌症靶向治疗
完整详情

诊断性检查

首要检查

  • 血清乙酰胆碱受体 (AChR) 抗体分析
  • 肌肉特异性受体酪氨酸激酶 (MuSK) 抗体
  • 系列肺功能试验
完整详情

需考虑的检查

  • 抗横纹肌受体抗体检测
  • 重复神经刺激
  • 单纤维 EMG
  • 胸部 CT
完整详情

治疗流程

急症处理

肌无力危象

持续性治疗

轻至中度疾病(I-III 类)

重度(IV 类或 V 类)或难治性疾病

撰稿人

作者

Robert P. Lisak, MD, FRCP (E), FAAN, FANA

Parker Webber Chair in Neurology

Professor of Neurology

Professor of Immunology and Microbiology

Wayne State University School of Medicine

Detroit

MI

利益声明

RPL is a Data and Safety Monitoring Board Member for the COUR myasthenia gravis clinical trial. RPL is a site principal investigator for clinical trials and a co-author for the clinical trial reports for myasthenia gravis therapies for Alexion, Argenx, and UCB Ra. RPL's institution receives payment for the time spent on these clinical trials. RPL has received book royalties from Oxford University Press and Blackstone, and has carried out consultancy work for Avilar.

鸣谢

Dr Robert Lisak would like to gratefully acknowledge Dr Andrea Corse and Dr Ami Mankodi, previous contributors to this topic.

利益声明

AC and AM declare that they have no competing interests.

同行评议者

Vern C. Juel, MD

Associate Professor of Medicine (Neurology)

Duke University

Durham

NC

利益声明

VCJ declares that he has no competing interests.

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