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https:\/\/video3.mingpao.com\/201608\/HET20160809_07.mp4\u773c\u77bc\u4e0b\u5782 \u4e2d\u98a8\uff1f\u7cd6\u5c3f\uff1f;https:\/\/video3.mingpao.com\/201608\/HET20160809_08.mp4\u91cd\u75c7\u808c\u7121\u529b\uff1a\u91cd\u5f71\u9bc1\u54bd;https:\/\/video3.mingpao.com\/201608\/HET20160809_09.mp4\u8a3a\u65b7\u91cd\u75c7\u808c\u7121\u529b \u51b0\u6577\u773c\u76ae;https:\/\/video3.mingpao.com\/201608\/HET20160809_10.mp4\u5927\u529b\u4e38\u6e1b\u8f15\u5fb5\u72c0;https:\/\/health2.mingpao.com\/ftp\/Health2\/20160926\/news\/_26ya101.jpg\uff08\u5716\uff1a\u9ec3\u5fd7\u6771\uff09;<\/inline><\/p>\n","protected":false},"excerpt":{"rendered":"

【明報專訊】眼耷耷，以為是眼瞓；手腳乏力，以為是疲勞；加上休息過後，情况紓緩，更似身體過勞。<\/p>\n

「重症肌無力」初期病徵不明顯，病人甚至醫生都容易掉以輕心。<\/p>\n

眼瞼下垂、重影、疲勞、四肢無力，隨時是重症肌無力找上門！<\/p>\n

「眼瞼下垂，是重症肌無力的早期典型徵狀，因為多是間歇性地出現，例如晚上、運動後較差，或令人掉以輕心。察覺徵狀後，病人一般多先向眼科求診，經過檢查及轉介，才轉到腦神經科處理。」養和醫院駐院醫生郭業東說。<\/p>\n

重症肌無力屬於免疫系統疾病。免疫系統誤當體內一種神經遞質「乙醯膽鹼受體」為敵人，作出攻擊。<\/p>\n

早期發病多見晚上或運動後<\/p>\n

「乙醯膽鹼」負責肌肉、神經之間的信息傳遞，當免疫系統不停攻擊乙醯膽鹼受體，影響了信息傳遞，導致肌肉無法收縮。徵狀方面，剛開始時，一般只局部影響眼部肌肉，導致眼瞼下垂、重影。腦神經科專科醫生張嘉琳解釋，大多數病人在病徵初起時，只在晚上或運動後，出現眼瞼下垂，這是因為肌肉活動了一天，又或經過激烈運動後，「用盡」了神經遞質，令到肌肉無力的徵狀變得嚴重。病情發展至中期，或會影響全身肌肉，包括呼吸、吞嚥肌肉等，導致呼吸不順、進食困難、口齒不清、四肢無力。<\/p>\n

重症肌無力成因未明 或涉遺傳<\/p>\n

張嘉琳指出，有一位48歲的男士，最初因為眼瞼下垂求診。「不料三個月後，病情急速惡化，除了呼吸困難，進食時更常常嗆到，需接受洗血、插喉等急性治療。由於病情反覆，其後再度入院，已經多次洗血，需增加使用免疫系統藥物，才可控制病情，屬於嚴重個案。」重症肌無力，成因仍未確定，「臨牀觀察，不少患者的家庭成員，出現相關的病史。估計具有一定的遺傳性，但仍未能顯示和特定基因有關」。<\/p>\n

病情惡化前，一般是否有先兆？「通常和感冒有關，令肌肉無力、呼吸不順更嚴重。」張嘉琳說，重症肌無力，從剛出生的嬰兒到成人，同樣可以患上。「但一般認為，40歲以下以女性及40歲以上男士，較為常見。」<\/p>\n

患者最擔心，重症肌無力是否必然會從局部性，轉變為全身性？「研究顯示，演變成全身性的個案，九成在發病首兩年發生；換句話說，如果三年內也沒變差，絕大部分不會惡化。然而，發病不一定從眼開始，有人最初發病，情况已較為嚴重，出現吞嚥困難，卻沒有眼瞼下垂。」<\/p>\n

文：陳雅君<\/p>\n

圖：黃志東<\/p>\n

編輯：王翠麗<\/p>\n

■有片睇<\/p>\n

想現場直擊家庭醫生睇醫生，可登入 www.mingpaohealth.com\/doc.htm<\/a><\/p>\n

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