低频重复神经电刺激疲劳试验对重症肌无力患者的诊断作用

doi:10.13481/j.1671-587x.20150341

吉林大学学报(医学版) ›› 2015, Vol. 41 ›› Issue (03): 652-655.doi: 10.13481/j.1671-587x.20150341

低频重复神经电刺激疲劳试验对重症肌无力患者的诊断作用

逄紫千¹, 王可人², 叶玉琴³, 张欣¹, 刘明军¹, 黄庆道⁴

1. 长春中医药大学针灸推拿学院实验教学中心, 吉林长春 130117;
2. 吉林大学中日联谊医院乳腺外科, 吉林长春 130033;
3. 吉林大学第一医院神经内科, 吉林长春 130021;
4. 吉林大学数学学院应用数学系, 吉林长春 130012

收稿日期:2015-03-03 发布日期:2015-08-01
通讯作者: 叶玉琴,主治医师(Tel:0431-88783565,E-mail:dearlea@sina.com) E-mail:dearlea@sina.com
作者简介:逄紫千(1970-),女,吉林省长春市人,高级实验师,医学硕士,主要从事针灸特定穴对神经系统疾病的作用机理方面的研究。
基金资助:
吉林省中医药管理局2015年科技项目资助课题(2014-ZD22,2014-Q31)

Diagnostic value of exercise test of low-frequency repetitive nerve stimulation in patients with myasthenia gravis

PANG Ziqian¹, WANG Keren², YE Yuqin³, ZHANG Xin¹, LIU Mingjun¹, HUANG Qingdao⁴

1. Department of Acupuncture and Massage, Experimental Teaching Center, Changchun University of Chinese Medicine, Changchun 130117, China;
2. Department ofBreast Surgery, China-Japan Union Hospital, Jilin University, Changchun 130033, China;
3. Department of Neurology, First Hospital, Jilin University, Changchun 130021, China;
4. Department of Applied Mathematics, School of Mathematics, Jilin University, Changchun 130012, China

Received:2015-03-03 Published:2015-08-01

摘要/Abstract

摘要：

目的:对重症肌无力(MG)患者行低频重复神经电刺激(RNS)检测中的疲劳试验,阐明疲劳试验对MG患者的诊断价值。方法:收集30例MG患者,对面神经进行静息状态低频RNS检测,并进行疲劳试验,分别疲劳1和2 min,在疲劳结束后的即刻、休息1 min及2 min再进行RNS检测。分析静息及疲劳后不同时间点RNS中复合肌肉动作电位(CMAP)波幅递减百分率的差异。结果:低频RNS疲劳试验各时间点CMAP波幅递减幅度均较静息状态递减幅度明显,30例患者中以疲劳2 min后休息1 min RNS递减幅度最明显。30例患者中12例患者RNS静息状态下CMAP波幅未见明显递减现象,而疲劳后CMAP波幅递减明显。结论:低频RNS疲劳试验可明显提高MG患者的诊断率,尤其对于静息状态下RNS检测正常的MG患者有效。检测时以疲劳2 min后休息1 min效果最明显。

关键词: 重症肌无力, 低频重复神经电刺激, 疲劳试验

Abstract:

Objective To perform the exercise test of low-frequency repetitive nerve stimulation(RNS) in the patients with myasthenia gravis(MG), and to clarify the diagnostic value of exercise test in the patients with MG. Methods 30 patients with MG were collected.The RNS at rest and exercise test in facial nerve were performed in all patients.Exercise test was performed at fatigue 1 min and 2 min, then the RNS was performed at the ending of fatigue, 1 min and 2 min after fatigue, respectively.The decreasing degree of compound muslce action potential (CMAP) amplitude at different time points were analyzed. Results The CMAP amplitudes in exercise test of RNS were decreased significantly when compared with RNS at rest at different time points, especially at fatigue 2 min and rest 1 min.Amang 30 patients, 12 patients had normal RNS at rest, but all of them had abnormal RNS after exercise test. Conclusion Exercise test of RNS has the diagnostic value in the patients with MG, especially in the patients with normal RNS at rest.Fatigue 2 min and rest 1 min could be considered when performing exercise test of RNS.

Key words: myasthenia gravis, repetitive nerve stimulation, exercise test

中图分类号:

R746.1

逄紫千, 王可人, 叶玉琴, 张欣, 刘明军, 黄庆道. 低频重复神经电刺激疲劳试验对重症肌无力患者的诊断作用[J]. 吉林大学学报(医学版), 2015, 41(03): 652-655.

PANG Ziqian, WANG Keren, YE Yuqin, ZHANG Xin, LIU Mingjun, HUANG Qingdao. Diagnostic value of exercise test of low-frequency repetitive nerve stimulation in patients with myasthenia gravis[J]. Journal of Jilin University Medicine Edition, 2015, 41(03): 652-655.

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低频重复神经电刺激疲劳试验对重症肌无力患者的诊断作用

Diagnostic value of exercise test of low-frequency repetitive nerve stimulation in patients with myasthenia gravis

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