摘要
目的探讨低频重复电刺激（RNS）检查在重症肌无力（MG）患者中的诊断作用。方法回顾性分析2008年7月至2010年8月住院确诊436例MG患者低频RNS的检查结果，分析MG患者中低频RNS阳性率，不同受检肌群及MG各临床分型低频RNS异常率。结果MG患者中低频RNS阳性率为73．85％。低频RNS异常以刺激面神经（82．30％）和腋神经（52．17％）高，尺神经（27．64％）最低；眼肌型MG患者低频RNS异常率（54．25％）明显低于全身型（84．45％）（P〈0．01），其中Ⅱa、Ⅱb、Ⅲ型与Ⅳ型MG患者低频RNS的阳性率分别为89．66％，82．56％，91．67％及83．33％，两两比较差异无统计学意义（P〉0．05）。16．34％眼肌型MG患者可出现腋、副或尺神经低频RNS异常，79．50％全身型MG出现两种或两种以上神经低频RNS阳性。结论低频RNS检查对MG的诊断有重要价值，以面神经和腋神经刺激检查阳性率较高。低频RNS异常率在全身型比眼肌型MG患者中更明显。
Objective To explore the value of low-frequency repetitive nerve stimulation （RNS） in the diagnosis of myasthenia gravis （MG）. Methods A total of 436 MG patients admitted during the period of July 2008 and August 2010 and undeergoing the repetitive nerve stimulation test were reviewed retrospectively. We analyzed the positive rates of RNS in MG patients and compared the abnormalities in different nerves including facial, accessory, axillary and ulnar nerves. Results Among them, 73.85% had abnormal recordings on low-frequency RNS test. The highest abnormality was in facial nerves （82.30%） , then axillary nerves （52. 17% ） and the lowest in ulnar nerves （27.64%）. The positive rates of RNS in ocular MG were significant lower than those in general MG patients. And there were no significant statistical differences of RNS abnormalrates in types Ⅱ a, Ⅱ b, Ⅲ and Ⅳ MG patients with 89. 66%, 82. 56%, 91.67% and 83.33% , respectively. In ocular MG, 16.34% patients were positive in RNS test under the stimulation of accessory, axillary and ulnar nerves. And 79.50% patients with general MG had two or more nerves with abnormal results. Conclusion The low-frequency RNS test is of great value in the diagnosis of MG. And it shows a higher sensitivity in general MG patients than that in ocular ones. The stimulation of facial and axillary nerves increases the positive rates of RNS in MG patients.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2011年第17期1178-1180,共3页
National Medical Journal of China
关键词
重症肌无力
电生理学
诊断
Myasthenia gravis
Electrophysiology
Diagnosis
