摘要
目的 探讨电刺激单肌纤维肌电图 (SSFEMG)技术在急性有机磷农药 (OPs)及其混剂中毒患者“中间期肌无力综合征”(IMS)诊断、分级及病情转归中的意义。方法 对 4 1例急性有机磷农药及其混剂中毒患者进行了SSFEMG和重频神经刺激肌电图 (RNS)检测。结果 ( 1)电刺激频率为 5Hz和 2 0Hz时 ,SSFEMG检测所见单肌纤维动作电位平均连续差 (MCD)增高与肌无力发生的一致性均较好 ( 5Hz:Kappa系数 =0 .63 4 ,P =0 .0 0 2 ;2 0Hz :Kappa系数 =1.0 0 0 ,P =0 .0 0 0 ) ,且以 2 0Hz者更好 ;RNS的检测结果与肌无力发生的一致性不如SSFEMG( 5Hz :Kappa系数 =0 .15 3 ,P =0 .4 0 0 ;2 0Hz :Kap pa系数 =0 .188,P =0 .3 19) ;( 2 )重型与轻型IMS患者MCD差异无显著性 [5Hz :轻型 ( 2 5 .4 3± 14 .0 8)μs、重型 ( 2 9.80± 14 .3 7) μs,P >0 .0 5 ;2 0Hz :轻型 ( 3 4 .3 0± 11.19) μs、重型 ( 3 9.4 0± 18.98) μs ,P >0 .0 5 ];( 3 )IMS患者肌力恢复后MCD明显下降 ,且趋于正常。结论 SSFEMG较同一频率的RNS敏感 ,可用于IMS的诊断与病情转归的评价 ,但在诊断分级中的意义还需进一步探讨。
Objective To explore the diagnostic and prognostic significance of stimulation single fiber electromyography(SSFEMG) in patients with intermediate myasthenia syndrome(IMS) induced by organophosphate insecticides(OPs) and their mixtures poisoning. Method Forty-one patients with acute OPs and their mixtures poisoning were detected with SSFEMG and repetitive nerve stimulation electromyography(RNS) at 5 Hz and 20 Hz after recovery from acute cholinergic crisis.Thirteen of them developed IMS and had repeated SSFEMG detection during myasthenia and after recovery from IMS. Results (1)There was a correlation between myasthenia and the neuromuscular transmission dysfunction detected by SSFEMG at both 5 Hz and 20 Hz,especially at 20 Hz[(5 Hz:Kappa coefficient=0.634,P=0.002;20 Hz:Kappa cofficient=1.000,P=0.000],but not by RNS;(2)The mean consecutive difference(MCD) was almost at the same level between mild and severe IMS patients[5 Hz: (25.43±14.08)μs vs.(29.80± 14.37)μs;20 Hz:(34.30±11.19)μs vs.(39.40±18.98)μs respectively,P> 0.05];(3)The MCD decreased obviously in IMS patients after their recovery from myasthenia. Conclusion SSFEMG is more sensitive than RNS in the diagnosis of IMS and is also valuable in prognosis prediction for IMS.
出处
《中华劳动卫生职业病杂志》
CAS
CSCD
北大核心
2001年第4期257-260,共4页
Chinese Journal of Industrial Hygiene and Occupational Diseases
基金
国家科学技术委员会"九五"科技攻关项目 ( 96 90 6 0 4 11)
关键词
有机磷农药
急性中毒
中间期肌无力综合征
电刺激单肌纤维肌电图
农药中毒
Organophosphate insecticides
Acute poisoning
Intermediate myasthenia syndrome
Stimulation single fiber electromyography
