瞬目反射与面神经运动传导检测在特发性面神经麻痹中的临床应用价值  

The clinical application values of blink reflex and facial nerve motor conduction test in patients with idiopathic facial paralysis

作　　者：王龙飞[1] 汪飞[1] 曹婷婷[2] 苏增锋 

机构地区：[1]黄山市人民医院神经内科,安徽245000 [2]黄山市人民医院神经电生理室,安徽245000 [3]安徽医科大学第三附属医院干部病房

出　　处：《脑与神经疾病杂志》2017年第6期353-358,共6页Journal of Brain and Nervous Diseases

摘　　要：目的探讨瞬目反射与面神经运动传导在特发性面神经麻痹中的临床应用价值。方法选取特发性面神麻痹患者101例,于发病3~7d内进行瞬目反射(BR)和面神经运动传导(FMC)检测,以评估其与临床表现、面瘫预后的关系。结果 101例患者BR检测均异常,表现为患侧R1、R2、R2'波潜伏期延长或未出波;在比较不同未出波情况的痊愈时间分布时发现,4组(全出波、1个未出波、2个未出波、3个未出波)间痊愈时间分布(P>0.05)。101例患者患侧额肌、眼轮匝肌、口轮匝肌M波潜伏期均较对侧延长,差异有统计学意义(P<0.05);101例患者患侧M波波幅均有下降,Pearson分析显示痊愈时间与患侧M波下降幅度呈正相关,(r=0.592,P<0.05)。按照患侧M波波幅较对侧下降幅度大小,分为50%以下、50%~80%、80%以上3组,3组间痊愈时间分布(P<0.05),下降幅度为50%以下组的患者80.4%在1个月内痊愈,下降幅度为50%~80%组的患者56.1%在2个月内痊愈,下降幅度80%以上组的患者77.8%在3个月及以上痊愈。结论特发性面神经麻痹患者患侧BR均异常,BR可作为其诊断的客观、敏感的指标;面神经运动传导检测,患侧M波波幅下降幅度与痊愈时间呈正相关,可客观评估其预后。Objective To investigate the clinical application values of blink reflex （BR） and facial nerve motor conduction （FMC） in patients with idiopathic facial paralysis （IFP）. Method The BR and FMC were detected in one hundred and one patients with IFP on the early stage from 3 days to 7 days, to assess their relationships with clinical manifestation and prognosis of IFP. Results The abnormal rate was 100% in all the patients,the ipsilateral R1, R2, R2 ＇ waves were recorded abnormal, showing the latencies prolonged or the absent wave. In the comparison of the recovery time distribution of the different abnormal BR cases, the difference among the 4 groups （full waves, one wave absent , 2 waves absent, 3 waves absent）was not significant（ P〉0.05）. FMC：The M wave latencies of the ipsilateral frontal muscle, orbicularis oculi muscle and orbicularis oris muscle were longer than the contralateral sides, and the differences were significant（ P〈0.05）.The ipsilateral M wave amplitude among the one hundred and one patients were all decreased. Pearson analysis showed the recovery time was positively correlated with the decrease of the ipsilateral M wave amplitude, and the recovery time was prolonged with the increase of the M wave amplitude attenuation（ r=0.592 P〈0.05）. According to the size of the ipsilateral M wave amplitude decline, divided into less than 50% of the group, 50%-80% of the group ,more than 80% of the group, there were significant differences in healing time amomg the 3 groups（ P〈0.05）. The 80.4% of the patients with less than 50% of the M wave amplitude decline recovered within 1 month, the 56.1% of the patients with a decrease in the magnitude of 50%-80% recovered within 2 months , and the 77.8% of the patients with more than 80% of M wave amplitude decline recovered in 3months or more than 3 months. Conclusion BR are abnormal in patients with IFP , it can be used as an objective and sensitive indicator of the diagnosis of IFP ; FMC

关 键 词：瞬目反射 面神经运动传导 特发性面神经麻痹 痊愈时间 

分 类 号：R745[医药卫生—神经病学与精神病学]