辅助检查方法对新发病重症肌无力的诊断价值  

Diagnostic Value of Auxiliary Examinations for New Onset Patients with Myasthenia Gravis

作　　者：殷剑[1] 王翠娣[1] 文诗广[1] 许贤豪[1] 

机构地区：[1]卫生部北京医院神经内科,北京100730

出　　处：《中国神经免疫学和神经病学杂志》2009年第2期94-96,共3页Chinese Journal of Neuroimmunology and Neurology

基　　金：卫生部北京医院院内青年基金资助项目(2005 951)

摘　　要：目的观察辅助检查方法对尚未经免疫治疗的新发病重症肌无力(MG)患者的诊断价值。方法回顾性分析156例诊断明确的新发病MG患者初诊时的临床电生理检查[主要包括重复电刺激(RNS)和单肌纤维肌电图(SFEMG)]、新斯的明试验、乙酰胆碱受体抗体(AChRAb)等资料。结果 156例新发病MG患者(无Ⅰ型患者)新斯的明试验以及SFEMG、RNS和AChRAb检查阳性者分别为135(86.5%)、129(82.7%)、108(69.2%)和99(63.5%)例。新斯的明试验和SFEMG阳性检出率差异无统计学意义(P>0.05),但均明显高于RNS和AChRAb阳性检出率(P<0.05)。结论 MG的诊断需要进行临床综合判断,各项辅助检查不可相互替代。对新发病MG患者规范化的新斯的明实验和SFEMG检查敏感性高。Objective To investigate the diagnostic value of commonly used auxiliary examinations in new onset patients with definitely diagnosed myasthenia gravis （MG）. Methods A total of 156 patients were enrolled into the study who visited department of neurology of Beijing Hospital during the period from January, 1999 to December,2004 and were diagnosed as patients with MG. They had been treated with repetitive nerve stimulation （RNS）, single fiber electromyography examination （SFEMG）, neostigmine test, and acetylcholine receptor antibody （AChRAb） determination. Results The positive cases of NST, RNS, SFEMG and AChRAh for the patients with definitely diagnosed MG were 135 （86.5%）, 129（82.7%）, 108（69.2%）, and 99（63.5%） cases respectively. There was no statistically significant difference between NST and SFEMG （P〉0.05）. There was significant difference between the positive rate of NST and that of RNS and AChRAb （P〈0.05）. There was significant difference between the positive rate of SFEMG and that of RNS and AChRAb （P〈0.05）. Conclusions Combined auxiliary examinations are necessary in making clinically correct diagnosis of MG. And NST and RNS have the highest sensitivity to diagnose new onset patients with MG.

关 键 词：重症肌无力 新斯的明试验 重复电刺激 单击纤维肌电图 乙酰胆碱受体抗体 

分 类 号：R746.1[医药卫生—神经病学与精神病学]