Titleysphonia as a primary manifestation in myasthenia gravis (MG): A retrospective review of 7 cases among 1520 MG patients.
标题： 1520例重症肌无力患者中7例以发声困难为首发表现的的回顾性调查
Authors:Liu WB, Xia Q, Men LN, Wu ZK, Huang RX.
Department of Neurology, the First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan 2nd Road, Guangzhou 510080, China.
作者：Liu WB, Xia Q, Men LN, Wu ZK, Huang RX.中国广州中山2路58号中山大学第一附属医院神经科，510080
Resource:J Neurol Sci. 2007 Apr 25; [Epub ahead of print]
来源：神经科学杂志。2007年4月25日（网络版）
Abstract:
摘要：
Myasthenia gravis (MG) is an autoimmune disorder of neuromuscular transmission, usually recognized with ocular complaints or generalized muscle weakness. However, among the 1520 MG cases that had been diagnosed and treated in our hospital in the last 15 years (1990-2005), we have identified 7 MG patients whose initial and prominent complaint was dysphonia and all had been misdiagnosed elsewhere.
重症肌无力（MG）是神经肌肉传递系统的自身免疫性疾病，常以眼症或全身性肌无力而发现。但在1990-2005年在我院诊断和治疗的1520例MG患者中，我们发现7例MG患者的最初和突出症状为发声困难，而他们之前在别处已被误诊。
The diagnoses were confirmed with fibrolaryngoscope and voice analysis employed before and after a positive neostigmine (anticholinesterase) test. Electromyography with repetitive stimulations, single-fiber electromyography, and laboratory and radiographic evaluations were also conducted for diagnosis.
该诊断在新斯的明（胆碱酯酶抑制剂）试验阳性之前或之后通过纤维喉镜检查和声学分析而被确定。重复刺激肌电图描记、单纤维肌电图描记记、实验室和影像学检查也用作辅助诊断。
A surprisingly low seropositivity rate of anti-acetylcholine-receptor antibodies (1/7) and anti-MuSK (Muscle Specific Kinase) antibodies (0/6) were found in these dysphonia MG patients. A cholinesterase inhibitor (ChEI) and immunosuppressive therapy were applied for treatment.
令人吃惊的是在这些发声困难的MG患者抗乙酰胆碱受体(1/7)抗体和抗MuSK（肌肉特异性激酶）抗体(0/6) 血清阳性率很低。一种胆碱酯酶抑制剂和免疫抑制疗法用于治疗。
Extended thymectomy was applied to MG patients with thymus hyperplasia or thymic tumor. Significant improvement was found in all 7 cases after these treatments. We have developed a sere of diagnostic protocol for this rare type of laryngeal MG, and discussed the clinical implication of our data.
扩大性胸腺切除手术则用于合并胸腺增生或胸腺肿瘤的MG患者。在这些治疗后，7例患者病情均有显著改善。目前我们已为此类罕见的喉型MG建立了系列性的诊断草案，并讨论了我们数据的潜在临床意义。
In summary, dysphonia or laryngeal disorder can be the only prominent manifestation of MG in rare cases, which should be taken into consideration during the diagnosis to patients with exclusive laryngeal complaints.
总的来说，发声困难或喉部功能障碍可能是一些罕见MG的突出表现，这应在对仅有喉部症状的病人进行诊断时加以考虑。
PMID: 17466337 [PubMed - as supplied by publisher]
编译：395字
重症肌无力可能以发声困难为首发和突出表现
中国广州中山大学第一附属医院神经科Liu WB等对1520例重症肌无力（MG）患者中7例以发声困难为首发表现的的回顾性调查认为，MG可能以发声困难为首发和突出表现。[神经科学杂志。2007年4月25日（网络版）]
Liu WB等发现，此7例最初和突出症状为发声困难的MG患者，在别处已被误诊。经过重复刺激肌电图描记、单纤维肌电图描记记、实验室和影像学检查，在新斯的明（胆碱酯酶抑制剂）试验阳性之前或之后通过纤维喉镜检查和声学分析而最终确立了喉型MG的诊断。惊人之处还在于在这些发声困难的MG患者抗乙酰胆碱受体(1/7)抗体和抗MuSK（肌肉特异性激酶）抗体(0/6) 血清阳性率很低。以胆碱酯酶抑制剂和免疫抑制法治疗，及对合并胸腺增生或胸腺肿瘤的MG患者行扩大性胸腺切除手术后，这些患者病情均有显著改善。目前他们已为此类罕见的喉型MG建立了系列性的诊断草案。
