Analysis Of Hormone Treatment Sensitivity Related Factors In Patients With Myasthenia Gravis

Objective: To analysis clinical and biochemical characteristics and factors related to steroid treatment sensitivity in patients with myasthenia gravis.To explore whether clinical heterogeneity of myasthenia gravis is complicated with other autoimmune diseases,and to find prediction factors associated with hormone therapy sensitivity in myasthenia gravis patients without other autoimmune diseases.Methods: Clinical and biochemical data of 266 MG patients in department of neurology from January 2000 to December 2014,was retrospectively analyzed.According to whether complicated other autoimmune diseases,MG patients were divided into with or without other autoimmune diseases groups,their clinical and biochemical characteristics were compared between the two groups.According to clinical symptoms and response to steroid,MG patients were divided into the sensitivity and resistance groups,and their clinical and biochemical characteristics were compared between the two groups.The association between the clinical and biochemical factors and response to steroid in MG patients was analyzed.Results: Patients with a total of 266 people,there were 171 examples not associated with other autoimmune diseases,accounted for 64.3%,95 cases accompanied by other immune diseases,accounted for 35.7%.117(44.0%)were male and 149(56.0%)were female;with a mean onset age of 44.23±18.5 years(range 1-83).There were statistically significant differences in sex,age of onset,hormone treatment sensitivity and level of CRP(P<0.05).There were no significant differences in premonitory symptom,onset,involved muscles,clinical classification,related antibodies,fatigue test,neostigmine test,repetitive nerve stimulation,abnormal thymus,hypertensive disease,drug allergy,proportion of abnormal blood sugar,serum lipid level,level of WBC and CRP(P>0.05).According to clinical symptoms and response to steroid,86 MG patients,without other autoimmune diseases,were divided into the sensitivity and resistance groups,and their clinical and biochemical characteristics were compared between the two groups.There were statistically significant differences in abnormal thymus(P<0.05).Between the normal and abnormal thymus groups,there were statistically significant differences in the response to steroid(X~2=5.01,P=0.03).The occurrence of resistance to steroid was positively correlated with abnormal thymus gland(r=0.237,P=0.03).63 MG patients,without autoimmune diseases,adopted high doses of hormones short-range shock therapy and detected serum lipid level before therapy.According to clinical symptoms and response to steroid,MG patients were divided into the sensitivity and resistance groups.There were statistically significant differences in serum lipid level,TC and LDL-C(P<0.05).Between the ortholiposis and dyslipidemia groups,there were statistically significant differences in the response to steroid(X~2=9.31,P<0.01);The occurrence of resistance to steroid was positively correlated with serum lipid level(r=0.384,P<0.01).Conclusions: Compared with MG patients without other autoimmune diseases,there were more female patients,earlier onset age,better hormone sensitivity and higher ESR level in MG patients with other autoimmune diseases.Abnormal thymus gland and higher blood lipid may decrease the clinical response to steroid in myasthenia gravis patients without autoimmune diseases,and the association may be beneficial to evaluate the clinical treatment and prognosis of MG patients.