单纤维肌电图在30例炎性肌病患者诊断中的应用  

Single fiber electromyography in diagnosis of patients with inflammatory myopathies

作　　者：崔丽英[1] 潘华[1] 翦凡[1] 汤晓芙[1] 陈琳[1] 李本红[1] 杜华[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院神经科,100730

出　　处：《中华神经科杂志》2005年第5期290-292,共3页Chinese Journal of Neurology

摘　　要：目的研究单纤维肌电图(SFEMG)在炎性肌病患者诊断中的价值和与其他辅助检查的关系。方法对30例(男9例,女21例)炎性肌病[其中多发性肌炎(PM)20例,皮肌炎10例)]患者进行伸指总肌SFEMG测定,并与常规肌电图(EMG)、血清肌酸激酶(CK)的测定结果及肌肉病理检查结果进行对比。结果30例患者伸指总肌SFEMG测定均异常,主要表现为纤维密度(FD)增高,部分患者伴有轻度的颤抖增宽,仅1例伴有1处阻滞。FD为1～6,平均为2.33±0.45。颤抖值为5～78μs,平均(41.7±10.8)μs;颤抖>55μs者所占百分比为0%～55%。常规EMG表现为肌源性损害21例(70%),神经源性损害2例(6.7%),正常7例(23.3%)。血清CK增高20例。肌肉病理符合PM和DM诊断者13例。结论常规EMG和CK正常及病理未见特征性改变但临床疑诊炎性肌病者,SFEMG的检查为其诊断提供了客观依据。ObjectiveTo study the value of single fiber electromyography (SFEMG) in diagnosis of inflammatory myopathies. Methods Extensor digitorum communis SFEMG,routine EMG and creatine kinase (CK) were measured in 30 patients (male 9, female 21) who were diagnosed as polymyositis (PM) and dermotomyositis (DM) by clinical features and neurophysiological tests and histology compared with normal controls.ResultsSFEMG showed a remarkably increased fiber density (FD) with normal or mildly increased jitter. FD ranged from 1.0~6.0 (mean 2.33±0.45); jitter ranged from 5~78 μs [mean (41.7±10.8) μs]; and the value of jitter>55 μs ranged from 0%~55%. Only one block was found in one subject. Routine EMG showed myogenic lesions in 21 (70%) patients, neurogenic lesions in 2 (6.7%) and normal pattern in 7 (23.3%). Pathological changes were consistent with those of PM and DM in 72.2% (13/18). Increased CK was found in 20 patients. ConclusionSFEMG is the most useful technique for diagnosing the clinically suspected patients who had normal routine EMG, normal CK and normal histology.

关 键 词：单纤维肌电图 炎性肌病 患者 诊断 肌酸激酶(CK) 神经源性损害 肌肉病理 多发性肌炎 肌源性损害 特征性改变 辅助检查 检查结果 测定结果 纤维密度 主要表现 EMG 皮肌炎 颤抖 百分比 血清 增高 平均 

分 类 号：R746[医药卫生—神经病学与精神病学]