摘要
目的分析胸腺瘤临床表现及消化系统症状的发生率。方法回顾性分析173例胸腺瘤临床资料。结果胸腺瘤常见首发症状是肌无力(53.75%)和肿瘤所致胸部不适症状(22.54%),部分患者体检偶然发现(13.29%)。患者具有突出的自身免疫倾向,可检测到多种自身抗体并伴随多种与免疫异常有关的疾病(副肿瘤综合征):神经系统疾病58.95%(重症肌无力56.65%)、内分泌疾病5.78%、第二肿瘤4.62%、血液系统疾病6.37%、结缔组织病1.73%、消化系统疾病1.16%。消化系统症状总发生率9.83%(17/173),以慢性腹泻最多(5.78%),多数腹泻病因不明。结论胸腺瘤具有突出的自身免疫倾向,临床表现差异大,伴随多种与自身免疫相关的疾病。不明原因的慢性腹泻常见,似与自身免疫性肠病有关。
Objective To investigate the clinical characteristics of thymomas and the incidence of gastrointestinal symptoms occurring in patients with thymoma. Methods The medical records of all 173 patients with thymoma in PUMC Hospital from 1985 to 2005 were analyzed. Results The most frequent initial manifestations of thymoma were fatigable weakness of extraocular, bulbar and/or limb muscles （53.75%）, followed by chest symptoms （22. 54% ）. 13.29% of the cases were accidentally found on routine chest roentgenography. This group of patients had remarkable predisposition to autoimmunity, which was characterized by many kinds of autoantibodies detected among them. Thymomas is associated with a long list of autoimmune conditions （so-called paraneoplastic syndromes）. The paraneoplastic syndromes found in this group of patients included myasthenia gravis（56. 65% ）, endocrinologic diseases （5.78 % ）, second tumors （4. 62% ）, hematologic disorders （6. 37 % ）, connective tissue diseases（ 1.73% ） ,gastrointestinal disorders（ 1.16% ）. 9. 83% （ 17/173 ） of patients showed notable gastrointestinal symptoms, most commonly chronic diarrhea （5.78%）, and the causes of most cases of diarrhea were unclear. Conclusions The clinical manifestations of thymoma are variable. Patients with thymoma show significant predisposition to autoimmunity and thymomas is associated with many autoimmune disorders. Chronic diarrhea associated with thymoma is not uncommon and the diagnosis of autoinamune enteropathy should be considered in such cases.
出处
《基础医学与临床》
CSCD
北大核心
2006年第8期897-901,共5页
Basic and Clinical Medicine
关键词
胸腺瘤
副肿瘤综合征
慢性腹泻
thymoma
paraneoplastic syndrome
chronic diarrhea
