nhược cơ - chẩn đoán, điều trị

nh îc c¬Ư
nh îc c¬Ư




§¹i c¬ng


 !"

#$%&%'"()*+, ()/012
3,

456789:;
<7=>1?$@A#

B:,,121?CD"

EFD@G!<H=,>
I<7
®Þnh nghÜa
J5K,L"9M-?
L>I8!?$!>8;
?:7E=<H=D!
E1L!N?3N,!
"O!-GP!QIE1L!
5K!,!2G1
P!I!R!-S!8$
:#H
Nh¾c l¹i sinh lÝ dÉn truyÒn

Nh¾c l¹i sinh lÝ dÉn truyÒn
ThÇn kinh qua synap
ThÇn kinh qua synap


Ac-CoenzymA
Ac-CoenzymA
+
+
Cholin
Cholin
Acetyltranferase
Acetyltranferase


Acetylcholin
Acetylcholin


Cholinesterase
Cholinesterase


Acetate
Acetate
Cholin
Cholin
§iÓm nèi TK-C¬ trong bÖnh nh%îc c¬
§iÓm nèi TK-C¬ trong bÖnh nh%îc c¬

►
T5!C!,!$5K!
T5!C!,!$5K!
<H=>1?$@A#
<H=>1?$@A#
►


U$5K!8<H=V(W6!5X"Y5
U$5K!8<H=V(W6!5X"Y5
X!
X!
►


 1L!8<5!Z !6 1L2!
 1L!8<5!Z !6 1L2!
D"
D"
►
!I!$!![I7@,,!
!I!$!![I7@,,!




>1?$@A#"31L\\!
>1?$@A#"31L\\!



!
!
\\]8K
\\]8K


-^_@A#!
-^_@A#!


:
:
,
,
=H\?$@A#!5X"Y5X!
=H\?$@A#!5X"Y5X!
`H\?$@A#!5XJ#$5K!8
`H\?$@A#!5XJ#$5K!8
<H=!
<H=!


!H
!H
CÊu tróc cña ReceptorAcetylcholin
CÊu tróc cña ReceptorAcetylcholin




<H=,T 1CD187
<H=,T 1CD187
!9M!
!9M!

<,!7H40H
<,!7H40H
Z3,!:",Ha<P
Z3,!:",Ha<P
4 ( ( (  H(!4 Pα β δ γ ε α
4 ( ( (  H(!4 Pα β δ γ ε α
bC3I:6=O
bC3I:6=O
FH(/4A(/H
FH(/4A(/H

>!8!RYI3,
>!8!RYI3,
1P!IbC3I:!c6
1P!IbC3I:!c6
=YI3]#1
=YI3]#1
FH
FH

!9I8!?3I:
!9I8!?3I:
6G8?7d,
6G8?7d,
D:6?7d Hα

D:6?7d Hα
Sinh bÖnh häc miÔn dÞch cña Nh%îc
c¬.
#8T5!!5K,-F8Y
187 !9MF!!@H
Bao gåm c¸c b»ng chøng:

)eA/e"NP@I8!<H=

@,5]!1:@J1C<H=

YG&!>bCD<H=3&!,
LY!N15K

N15K9!3ZfE"O!
75!787g6@I8!<H=

h,!i!1L@Y15K
"H
C¬ chÕ g©y nhîc c¬ qua
C¬ chÕ g©y nhîc c¬ qua
trung gian KT
trung gian KT
C¸c KT g©y gi¶m sè lîng
R.Ach qua 3 c¬ chÕ


#8@!c,8<H=
#8@!c,8<H=



G8
G8
-;!D<H=
-;!D<H=


@!N"I8bC3I:D=
@!N"I8bC3I:D=
>bC#(/4A#(/
>bC#(/4A#(/
@!NT5!81?:7$
@!NT5!81?:7$
@A#
@A#
Nguån gèc cña qu¸ tr×nh ®¸p øng tù
miÔn trong MG
1.: jh3F1:!i!$D
"-*0e"P"G5X!_
: )0e!77(0e
: 

#c: Y7d6`15K

:",,`k: D"7
!>6<H=:",,`]
8!>H
2. :j`Y,-9l7
D87Nm!F8Y187
!g68:$MS!83f$

MS!,PGf!$!8<H=H

J!5XG@DnW+"3I:6
a77-D7

#P97 !l![Io,<H=H
H#8:$_!,8"G5X!D
H#8:$_!,8"G5X!D
F8Y1_,gP?,!I
F8Y1_,gP?,!I
!c
!c

#P9I:K7![6h=A`)h=A
#P9I:K7![6h=A`)h=A
g,h=Agp4H
g,h=Agp4H
Sù kÕt hîp gi÷a c¸c bÖnh tù
miÔn kh¸c vµ MG

`G5X!: jF8
`G5X!: jF8
77
77

#8"9Mjq3:!87"
#8"9Mjq3:!87"
q@gh7"-9M_
q@gh7"-9M_
m!1YP"9MH

m!1YP"9MH

#8:$EKf1oj#5X!
#8:$EKf1oj#5X!
!87!87MS!1_b"
!87!87MS!1_b"
"O!8$5!-
"O!8$5!-
F$$!>b7
F$$!>b7

#8"CI8jh\8815X!l
#8"CI8jh\8815X!l
A838"E=
A838"E=
r!Z5!H
r!Z5!H
TriÖu chøng l©m sµng
TriÖu chøng l©m sµng
Giảm cơ lực sau khi vận động và phục hồi sau
khi nghỉ ngơi: là dấu hiệu quan trọng nhất của
bệnh


QE1L!Q8!
,E1L!P?Q8I!
!9:7,E1L!f1PH

Q15K7;iI!R!
2I-S!$ :


qbCD"bT5!
qbCD"bT5!
J!5XP"bT
J!5XP"bT
5!
5!
JP]c,c
JP]c,c



%G6nA*e8
%G6nA*e8

U;7,-G6Gjhf1dL
U;7,-G6Gjhf1dL
"36!D-EI!;7
"36!D-EI!;7
2!-d!!,
2!-d!!,

#ErQI!1_4"3,"
#ErQI!1_4"3,"
Y1
Y1
JP8L,s
JP8L,s

%GL

%GL

JPf1d,tQ-d!cFr!
JPf1d,tQ-d!cFr!

JQ2!I!15K,
JQ2!I!15K,
-56MZ$!H
-56MZ$!H

J$IP-d,$"[,"2
J$IP-d,$"[,"2
!u
!u

h5v,6P?G[!r
h5v,6P?G[!r
>-w5vH
>-w5vH

h]2,l21X1^G>
h]2,l21X1^G>
Il"?LYJl2D!5X!D!E
Il"?LYJl2D!5X!D!E
#8],N
#8],N

#8!$2!!w#
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