中国医药科学
中國醫藥科學
중국의약과학
CHINA MEDICINE AND PHARMACY
2014年
17期
166-168
,共3页
重复神经电刺激%重症肌无力眼肌型%低频
重複神經電刺激%重癥肌無力眼肌型%低頻
중복신경전자격%중증기무력안기형%저빈
Myasthenia gravis%Myasthenia of eye muscle%Low frequency
目的：探讨神经重复电刺激检查在重症肌无力（MG）眼肌型患者的诊断价值。方法对46例临床拟诊的重症肌无力（MG）眼肌型患者进行神经重复电刺激检查，并对结果进行分析。结果共测试46例MG眼肌型患者，单上睑下垂者20例，双眼睑下垂者19例，复视者有3例，吞咽困难者2例，咀嚼无力2例。共对204条神经进行神经电生理检测：MG眼肌型患者在疲劳试验前，单独刺激眼轮匝肌、三角肌和小指展肌RNS的阳性率分别为41.30%（19/46）、15.21%（7/46）、6.52%（3/46），3块肌肉综合统计低频刺激的阳性率为58.69%（27/46），高频刺激的阳性率为5%（6/46）。疲劳试验后眼轮匝肌、三角肌和小指展肌RNS阳性率分别为47.82%（22/46）、21.74%（10/46）、6.52%（3/46）。疲劳试验前后可见低频刺激阳性率均远高于高频刺激，且高频刺激阳性者在低频刺激时全部为阳性。疲劳试验后三角肌的RNS阳性率增加；面肌、小指展肌的RNS阳性率无明显变化；3块肌肉综合统计低频刺激下RNS阳性率增高。结论 MG为神经-肌肉接头传递功能障碍的获得性免疫性疾病，神经重复电刺激检查对MG眼肌型的诊断、鉴别诊断及指导治疗有重要价值。
目的：探討神經重複電刺激檢查在重癥肌無力（MG）眼肌型患者的診斷價值。方法對46例臨床擬診的重癥肌無力（MG）眼肌型患者進行神經重複電刺激檢查，併對結果進行分析。結果共測試46例MG眼肌型患者，單上瞼下垂者20例，雙眼瞼下垂者19例，複視者有3例，吞嚥睏難者2例，咀嚼無力2例。共對204條神經進行神經電生理檢測：MG眼肌型患者在疲勞試驗前，單獨刺激眼輪匝肌、三角肌和小指展肌RNS的暘性率分彆為41.30%（19/46）、15.21%（7/46）、6.52%（3/46），3塊肌肉綜閤統計低頻刺激的暘性率為58.69%（27/46），高頻刺激的暘性率為5%（6/46）。疲勞試驗後眼輪匝肌、三角肌和小指展肌RNS暘性率分彆為47.82%（22/46）、21.74%（10/46）、6.52%（3/46）。疲勞試驗前後可見低頻刺激暘性率均遠高于高頻刺激，且高頻刺激暘性者在低頻刺激時全部為暘性。疲勞試驗後三角肌的RNS暘性率增加；麵肌、小指展肌的RNS暘性率無明顯變化；3塊肌肉綜閤統計低頻刺激下RNS暘性率增高。結論 MG為神經-肌肉接頭傳遞功能障礙的穫得性免疫性疾病，神經重複電刺激檢查對MG眼肌型的診斷、鑒彆診斷及指導治療有重要價值。
목적：탐토신경중복전자격검사재중증기무력（MG）안기형환자적진단개치。방법대46례림상의진적중증기무력（MG）안기형환자진행신경중복전자격검사，병대결과진행분석。결과공측시46례MG안기형환자，단상검하수자20례，쌍안검하수자19례，복시자유3례，탄인곤난자2례，저작무력2례。공대204조신경진행신경전생리검측：MG안기형환자재피로시험전，단독자격안륜잡기、삼각기화소지전기RNS적양성솔분별위41.30%（19/46）、15.21%（7/46）、6.52%（3/46），3괴기육종합통계저빈자격적양성솔위58.69%（27/46），고빈자격적양성솔위5%（6/46）。피로시험후안륜잡기、삼각기화소지전기RNS양성솔분별위47.82%（22/46）、21.74%（10/46）、6.52%（3/46）。피로시험전후가견저빈자격양성솔균원고우고빈자격，차고빈자격양성자재저빈자격시전부위양성。피로시험후삼각기적RNS양성솔증가；면기、소지전기적RNS양성솔무명현변화；3괴기육종합통계저빈자격하RNS양성솔증고。결론 MG위신경-기육접두전체공능장애적획득성면역성질병，신경중복전자격검사대MG안기형적진단、감별진단급지도치료유중요개치。
Objective To evaluate the diagnostic utility of repetitive nerve stimulation in ocular myasthenia gravis. MethodsA total of 46 cases of clinically diagnosed with ocular myasthenia gravis were underwent RNS test, and the results were analyzed.ResultsIn the 46 cases of ocular MG, 20 cases of single ptosis, double ptosis in 19 cases, diplopia in 3 cases; dysphagia in 2 cases and inability to chew in 2 cases. A total of 204 nerve underwent electrophysiological testing: Before ocular fatigue test, RNS positive rate was 41.30% (19/46), 15.21% (7/46), 6.52% (3/46), respectively stimulating alone orbicularis muscle, deltoid and little finger abductor. Three muscles comprehensive statistics of low frequency stimulation positive rate was 58.69% (27/46), the positive rate was 5% (6/46) of high frequency stimulation. Whileafter the fatigue test orbicularis muscle, deltoid and little finger abductor muscle RNS positive rate was 47.82% (22/46), 21.74% (10/46 ), 6.52% (3/46). Visible low-frequency stimulation before and after fatigue testing positive rate is much higher than the high-frequency stimulation, and high-frequency stimulation positive stimulation at low frequencies are all positive. After fatigue test of the deltoid muscle RNS positive rate increased; Facial muscles, the little finger abductor muscle of RNS positive rate has no obvious change; 3 muscles comprehensive statistical RNS under low frequency stimulation increased positive rate.Conclusion MG is nerve-neuromuscular transmission dysfunction acquired autoimmune disease, repetitive nerve stimulation has significant value in diagnosis, differential diagnosis and guide treatment of ocular myasthenia gravis.
