摘要
目的 探讨节段性运动神经传导测定在慢性炎性脱髓鞘性多发性神经根神经病（chronic inflammatory demyelinating polyradiculoneuropathy,CIDP）和腓骨肌萎缩症1型（Charcot-MarieTooth type1,CMT1）鉴别诊断中的价值.方法 收集16例CIDP和13例CMT1患者,进行节段性运动神经传导测定,比较两组远端运动潜伏期、运动神经传导速度,以及近端和远端比较复合肌肉动作电位波幅、面积和时限变化的差异.结果 CIDP和CMT1患者远端运动潜伏期分别为（5.6±3.4）、（9.3±2.1）ms（t=5.347,P=0.000）,运动传导速度分别为（31.1±14.3）、（22.2±5.8）m/s（t=6.369,P=0.000）,近端和远端比较波幅下降百分比M5o分别为29.7%和4.9%（Z=7.141,P=0.000）.在CIDP患者,所有测定神经中40.3%（25/62）远端潜伏期正常,18.1%（26/144）的神经节段传导速度正常,而在CMT1中所有测定神经的远端潜伏期均延长,所有测定节段的传导速度均减慢.在CIDP患者29.2%的神经节段可见传导阻滞或异常波形离散,而在CMT1仅有3.0%的节段可见传导阻滞（x2=20.829,P=0.000）.结论 当针对CIDP和CMT1进行鉴别时,如果节段性运动神经传导测定发现传导阻滞和异常波形离散、不同神经节段传导速度下降程度差别较大,可以支持 CIDP的诊断.
Objective to assess the utility of segmental motor nerve conduction study in differential diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy（CIDP）and Charcot-Marie-Tooth type 1（CMT1）.Methods A segmental motor nerve conduction study was performed on 16 patients with CIDP and 13 patients with CMT1.Distal motor latency,motor nerve conduction velocity,the changes of amplitude,area and duration of compound motor action potential over conventional segment were compared between the groups.Results Distal motor latency was （5.6±3.4） ms in CIDP and （9.3±2.1） ms in CMT1（t=5.347 P=0.000）,motor nerve conduction velocity was （31.1±14.3） m/s in CIDP and（22.2±5.8）m/s（t=6.369,P=0.000）,M50 of the decrease in amplitude over conventional segment was 29.7% in CIDP and 4.9% in CMT1 （Z=7.141,P=0.000）.Distal motor latency was normal in 40.3% （25/62） nerves and motor nerve conduction velocity was normal in 18.1% （26/44）of segments in CIDP,while distal motor latency and motor nerve conduction velocity were abnormal in all nerves in CMT1.Motor nerve conduction block or abnormal temporal dispersion was detected in 29.2% segments in CIDP and 3.0% in CMT1 （x2=20.829,P=0.000）.Conclusions The segmental motor nerve conduction study can help separate CIDP and CMT1.When motor nerve conduction block or abnormal temporal dispersion is detected,the motor nerve conduction velocity is distinctly various in different segments,the diagnosis of CIDP but not CMT1 should be considered.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2010年第11期756-759,共4页
Chinese Journal of Neurology
