Introduction The effect of thymectomy on the treatment of childhood-onset myasthenia gravis (CMG) remains debatable. The objective of this study was to evaluate the clinical outcome and relevant prognostic factors of thymectomy for CMG patients.

Materials and Methods A total of 32 CMG patients who underwent thymectomy before 18 years of age were included in this retrospective study. Clinical state following thymectomy was assessed by quantified myasthenia gravis (QMG) scores, myasthenia gravis–related activities of daily living (MG-ADL) scores, and Myasthenia Gravis Foundation of America postintervention status. Repeated-measures analysis of variance (ANOVA) examined the changes in postoperative scores during the 5-year follow-up. Univariate logistic regression was applied to identify factors associated with short-term (1-year postoperation) and long-term (5-year postoperation) clinical outcomes.

Results Repeated-measures ANOVA showed that QMG scores (F = 6.737, p < 0.001) and MG-ADL scores (F = 7.923, p < 0.001) decreased gradually with time. Preoperative duration (odds ratio [OR] = 0.85, 95% confidence interval [CI]: 0.73–1.00, p = 0.043), gender (OR = 0.19, 95% CI: 0.04–0.94, p = 0.041), and MG subgroup (OR = 13.33, 95% CI: 1.43–123.99, p = 0.023) were predictors for 1-year postoperative prognosis. Shorter disease duration (OR = 0.82, 95% CI: 0.70–0.97, p = 0.018) and generalized CMG (OR = 6.11, 95% CI: 1.06–35.35, p = 0.043) were found to have more favorable long-term results.

Conclusion Our results suggest that thymectomy is effective in treating CMG. Thymectomy could be recommended for CMG patients, especially for patients in the early course of GMG.

引言 胸腺切除术对治疗儿童期重症肌无力 (CMG) 的效果仍有争议。本研究的目的是评估 CMG 患者胸腺切除术的临床结果和相关预后因素。

材料和方法 本回顾性研究共纳入 32 名在 18 岁之前接受过胸腺切除术的 CMG 患者。胸腺切除术后的临床状态通过量化的重症肌无力 (QMG) 评分、重症肌无力相关的日常生活活动 (MG-ADL) 评分和美国重症肌无力基金会干预后状态进行评估。重复测量方差分析 (ANOVA) 检查了 5 年随访期间术后评分的变化。应用单变量逻辑回归来确定与短期（术后 1 年）和长期（术后 5 年）临床结果相关的因素。

结果 重复测量方差分析显示 QMG 分数 ( F  = 6.737, p  < 0.001) 和 MG-ADL 分数 ( F  = 7.923, p  < 0.001) 随时间逐渐下降。术前持续时间（比值比 [OR] = 0.85，95% 置信区间 [CI]：0.73–1.00，p  = 0.043），性别（OR = 0.19，95% CI：0.04–0.94，p  = 0.041）和 MG 亚组(OR = 13.33, 95% CI: 1.43–123.99, p  = 0.023) 是术后 1 年预后的预测因子。病程较短 (OR = 0.82, 95% CI: 0.70–0.97, p  = 0.018) 和广义 CMG (OR = 6.11, 95% CI: 1.06–35.35, p  = 0.043) 被发现具有更有利的长期结果.

结论 我们的结果表明胸腺切除术可有效治疗 CMG。对于 CMG 患者，特别是 GMG 早期病程的患者，可以推荐胸腺切除术。