To evaluate the efficacy, recurrent risk factors and transferable ratio of treatments with 3 different regiments on children with systematic myasthenia gravis (MG). Methods: The data of 104 children with ocular MG from June 2010 to March 2014 were collected from Department of Pediatric Neurology of Xiangya Hospital and they were retrospectively studied. The patients were divided into 3 groups: a methylprednisolone group (n=44), a prednisone group (n=48) and a bromine pyridostigmine group (n=12). Evaluative system from American MG foundation was used to evaluate the efficacy of treatment and the ratio of ocular MG transformed into systematic MG. Results: The efficacy in the methylprednisolone group was better than that in the prednisone group, and both of them were better than that in the bromine pyridostigmine group (both P<0.05).Methylprednisolone, prednisone combined with bromine pyridostigmine could reach a better long-term efficacy in children with ocular MG. Early treatment with glucocorticoid could reduce clinical relapse. Conclusion: A treatment with high-dose methylprednisolone pulse can improve early clinical remission in children with ocular MG. However, there is a similar efficacy in the long run of different glucocorticoid therapeutic regiments. A relatively order onset age, infection and thyroid dysfunction are recurrent risk factors in children with ocular MG.
目的：观察不同方案治疗儿童眼肌型重症肌无力(myasthenia gravis，MG)的效果、复发影响因素及向全身型MG转化的转化率。方法：对2010年6月至2014年3月于中南大学湘雅医院小儿神经专科就诊的104例儿童眼肌型MG患者进行回顾性临床研究。按治疗方案分为甲基强的松龙组(n=44)、强的松组(n=48)和单用溴吡斯的明组(n=12)。采用美国MG基金会干预后状态评价系统评价治疗有效率、向全身型MG转化的转化率。结果：甲基强的松龙组较强的松组短期内的治疗有效率提高，这两组患者的有效率均高于单用溴吡斯的明组(均P<0.05)。联合使用甲基强的松龙、强的松和溴吡斯的明治疗儿童眼肌型MG的远期疗效较好。早期糖皮质激素治疗可有效减少复发。结论：大剂量甲基强的松龙冲击治疗对于眼肌型MG患儿早期症状缓解起积极作用，而不同方案的糖皮质激素治疗远期疗效相似，起病年龄大、感染、甲状腺功能异常的儿童眼肌型MG患者复发率较高。.