重症肌无力合并肌电图肌源性损害53例临床和电生理特点  

Clinical and electrophysiologicalfeatures of myasthenia gravis with myogenic damage in 53 patients

作　　者：张兴文[1] 崔丽英[1] 管宇宙[1] 刘明生[1] 

机构地区：[1]中国医学科学院北京协和医院神经科,100730

出　　处：《中华神经科杂志》2007年第12期812-815,共4页Chinese Journal of Neurology

摘　　要：目的研究重症肌无力(myasthenia gravis,MG)合并肌电图肌源性损害患者的临床和电生理特点。方法收集1998—2006年中国医学科学院北京协和医院神经科肌电图室收治的 MG合并肌源性损害患者共53例,对其临床和电生理特点进行回顾性分析。结果在本组患者中,早发型患者占69.81%(37/53),早发型中女性患者明显多于男性(分别为26例和11例,X^2=5.281,P<0.05)。延髓部肌肉受累者多见,占50.94%(27/53)。仅1例患者具有肌肉萎缩的临床表现。合并其他免疫相关疾病患者占15.09%(8/53)。2例患者(3.77%)重复频率电刺激正常,但肌电图示肌源性损害。15例患者进行肌酶谱检查,其中1例轻度异常。结论对于 MG 合并肌源性损害的患者,要结合临床特征、电生理检查等进行综合分析来区别"真性"和"假性"的肌源性损害。行甲状腺功能、自身抗体等检查有助于发现潜在的自身免疫系统疾病。Objective To study the clinical and electrophysiological features of myasthenia gravis （MG） accompanied by myogenic lesion. Methods The data of the patients who were diagnosed MG accompanied by myogenic lesion from 1998 to 2006 were collected in EMG Room, Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and were retrospectively analyzed. Results In this group of 53 patients, myogenic lesion was found more often in patients with early-onset MG than those with late-onset （69. 81% vs 30. 20% ）, and among the early-onset patients the frequency of female was significantly higher than male （26 vs 11 ,X^2 =5.281, P 〈0. 05）. A large number of patients presented with a bulbar weakness （27/53,50.94%）. Muscular atrophy was found only in 1 of 53 patients. Patients with myogenic lesion were also prone to have other immune disorders （ 8/53,15.09% ）. There were 2 patients whose repetitive nerve stimulation was normal but EMG showed myogenic lesion. CK was abnormal in 13.3% patients. Conclusions In this group of patients, the clinical feature and electrophysiological test should be analyzed for the distinction of genuine and false myogenic lesion. The thyroid function and autologous antibody tests contribute to finding out the patients＇ potential autoimmune diseases.

关 键 词：重症肌无力 肌电描记术 电生理学 

分 类 号：R746[医药卫生—神经病学与精神病学]