Risk factors of myasthenic crisis after thymectomy: a meta analysis
10.3760/cma.j.issn.1001-4497.2015.011.006
- VernacularTitle:胸腺切除术后发生肌无力危象危险因素的Meta分析
- Author:
Yu LIU
;
Yusheng SHU
- Publication Type:Journal Article
- Keywords:
Myasthenia gravis;
Thymectomy;
Myasthenic crisis;
Meta-analysis
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2015;31(11):660-664
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the risk factors of myasthenic crisis after thymectomy for myasthenia gravis.Methods Meta-analysis was performed to screen risk factors of myasthenic crisis after thymectomy for myasthenia gravis based on 21 associated articles published and carried out using Stata12.0.Results Twenty one studies were identified, including 3 092 patients and 698 patients developed myasthenic crisis after thymectomy.Complicated with thymoma(OR =3.93, 95% CI 2.37-6.50, P =0.000), Ossermen classification (OR =0.12, 95 % CI 0.09-0.17 , P =0.000) , history of preoperative myasthenic crisis (OR =5.36, 95 % CI 3.82-7.51, P =0.000) , use steroid hormonea (OR =1.75,95 % CI 1.26-2.43, P =0.001) , postopertive lung infection(OR =4.27,95% CI 1.63-11.18, P =0.003) , operation methods(OR =0.34,95% CI 0.21-0.56, P =0.000) , the dose of preoperative anticholinesterase drags (OR =0.35, 95 % CI 0.18-0.66, P =0.000) ,pulmonary function(OR =0.18, 95% CI 0.06-0.57, P =0.004), preoperative serum level of anti-acetylcholine receptor antibody(OR =0.06, 95% CI0.03-0.13, P =0.000)were associated with myasthenic crisis after thymectomy.Gender, course of disease were not associated with myasthenic crisis after thymectomy.Conclusion With thymoma, Ossermen classification, history of preoperative myasthenic crisis, use steroid hormonea, operation methods, the high dose of preoperative anticholinesterase drugs, poor pulmonary function, postopertive lung infection, high preoperative serum level of anti-acetylcholine receptor antibody are risk factors affecting myasthenic crisis after thymectomy.