重症肌无力患者Jitter值及肌纤维密度测定研究  

Jitter and Fiber Density Study in Myasthenia Gravis

作　　者：陈向军[1] 程源深[1] 周宝礼[1] 陈怀红[1] 

机构地区：[1]浙江医科大学附属第二医院神经科,杭州310009

出　　处：《中国神经免疫学和神经病学杂志》1997年第2期82-86,共5页Chinese Journal of Neuroimmunology and Neurology

基　　金：浙江省卫生厅科研基金!96014

摘　　要：运用单纤维肌电图（SFEMG）技术对49例重症肌无力（MG）患者和35例正常人进行了Jitter值、肌纤维密度（FD）值测定，同时结合低频重复电刺激（IFRNS）、烟碱型乙酰胆碱受体抗体（nAchRab）测定作了对比研究。结果显示:MG患者的Jitter明显增宽（P＜0.01）;SFEMG检出MG比LFRNS与nAchRab测定阳性率高（P＜0.05），而且发现临床尚未出现肌无力症状的肌肉中也存在潜在的神经肌肉传递障碍;MG患者FD值无明显增高（P＞0.05）。从而提示，Jitter测定对诊断MG是一项敏感性较高的电生理技术，FD测定可作为区分MG患者与其它神经肌肉疾病患者Jitter异常的一个良好指标。Objective We intended to study the diagnostic yield of jitter and fiber density(FD)measurement to myasthenia gravis (MG) by single fiber electromyography (SFEMG)technique.Methods 49 patients with MG and 35 normal controls were selected. We measured jitter and FD value in both patients and normal controls by SFEMG, which was performed through Nicolet Viking- Ⅱ electromyograph, meanwhile low-frequency repetitive nerve stimulation (LFRNS)and nicotinic acetylcholine receptor antibody (nAchRab)assay were also studied in these patients. Results The mean MCD of the MG patients was significantly increased than that of normal controls (P <0. 01). SFEMG was superior to LFRNS and nAchRab assay in diagnostic sensitivity (P <0.05),and it facilitated to demonstrafe the potentially abnormal neuromuscular transmission in symptomless muscles of MG patients. There was no signiflcant increment in FD value in MG patients (P <0. 05). Conclusion Jitter rneasurement was a kind of more sensitive electrophysiological technique in the diagnosis of MG,while FD measurement aided to distinguish the abnormal jitter of MG from that of other nerve and muscle diseases.

关 键 词：重症肌无力 单纤维肌电图 肌纤维密度 JITTER 

分 类 号：R746.104[医药卫生—神经病学与精神病学]