重症肌无力患者单纤维肌电图与低频重复电刺激测定的对比研究  

Comparative study on single fiber electromyography and low frequency repetitive nerve stimulations in patients with myasthenia gravis.

作　　者：陈向军[1] 程源深[1] 周宝礼[1] 

机构地区：[1]浙江医科大学附属第二医院神经科

出　　处：《临床脑电学杂志》1996年第3期141-144,共4页

摘　　要：通过对４６例确诊的重症肌无力（ＭＧ）患者进行低频重复电刺激（ＬＦＲＮＳ）和单纤维肌电图（ＳＦＥＭＧ）的对比研究，部分病例还作了常规同心针极肌电图（ＣＮＥＭＧ）检查。发现ＬＦＲＮＳ阳性率为５７％。受检的三组肌肉中三角肌阳性率最高（４８％）。ＳＦＥＭＧ阳性率为９１％，其中轻型（改良Ｏｓｓｅｒｍａｎ分型中Ⅰ、Ⅱ＿Ａ型）为８８％，重型（Ⅱ＿Ｂ、Ⅲ、Ⅳ和Ｖ型）为１００％。两种检查阳性率有显著性差异（Ｐ＜０．０１）。ＳＦＥＭＧ是目前诊断ＭＧ最为敏感的电生理方法。轻型ＭＧ临床未表现肌无力的肌肉中也存在着潜在的神经肌肉传递障碍。Ｊｉｔｔｅｒ阻滞率是反映ＭＧ病情严重程度的良好指标。ＣＮＥＭＧ有助于排除和发现临床上症状相似的其它疾病或其它疾病同时伴发ＭＧ者。The comparison between single fiber electromyography (SFEMG) and low frequency repetitive nerve stimulations (LFRNS) in 46 patients with myasthenia gravis (MG) was studied, in whom 20 were also examined by a conventional needle-electrode electromyography (CNEMG). The positivity rate of LFRNS was 56. 52%,the abnormality of the deltoid muscle tested among three muscles was the highest (48%) and the positivity of SFEMG accounted for 91. 30% in which the mild type (modified Osserman Classification: Type Ⅰ,ⅡA) made up 88 24%,severe type (Type ⅡB,Ⅲ,Ⅳ,V)100%.Statistically, there was a significant difference between them (P<0.01). Currently. SFEMG might be the most sensitive method in the diagnosis of MG. The asymptomatic muscles in the mild type MG also demonstrated the pontential abnormal neuromuscular transmission. Impulse blocking was a valuable parameter in reflecting the severity of the disease and CNEMG was favorable to exclude and discover the diseases that were similar to or associated with MG.

关 键 词：重症肌无力 单纤维肌电图 低频重复电刺激 

分 类 号：R746.104[医药卫生—神经病学与精神病学]