摘要
目的对比重复神经刺激(RNS)在肌萎缩侧索硬化(ALS)和重症肌无力(MG)患者的应用价值。方法2017年10月—2019年10月随机选取宁波市医疗中心李惠利医院东部院区收治的50例ALS患者(试验组)及同期收治的50例MG患者(对照组)为研究对象,两组患者均进行RNS。记录两组患者不同神经RNS阳性率,尺神经、副神经RNS递减幅度,病程,拇短展肌(APB)/小指展肌(ADM),改良肌萎缩侧索硬化功能评分(ALFSRS-r评分),正中神经CMAP波幅,尺神经CMAP波幅等情况,并比较两组间有无差异。结果ALS患者副神经RNS阳性率高于尺神经(χ~2=45.019,P<0.001)。MG患者副神经RNS阳性率高于面神经RNS阳性率(χ~2=4.058,P=0.044),面神经RNS阳性率高于正中神经RNS阳性率(χ~2=4.340,P=0.037),正中神经RNS阳性率高于尺神经RNS阳性率(χ~2=4.336,P=0.037)。ALS患者尺神经、副神经RNS递减幅度低于MG患者(P<0.05)。RNS阳性患者正中神经CMAP波幅、尺神经CMAP波幅低于RNS阴性患者(P<0.05)。结论ALS患者RNS递减幅度低于MG患者,RNS递减幅度减弱,提示ALS患者病情加重,因此加强RNS测定,对于评估ALS患者预后意义重大。
Objective To compare the value of repetitive nerve stimulation(RNS)in patients with amyotrophic lateral sclerosis(ALS)and myasthenia gravis(MG).Methods 50 ALS patients(experimental group)and 50 MG patients(control group)admitted to Ningbo Medical Center Lihuili Eastern Hospital were randomly selected as research objects,and RNS was performed in both groups from October 2017 to October 2019.Different RNS positive rates,RNS decreasing amplitude of ulnar and accessory nerves,course of disease,APB/ADM,improved ALS score(ALFSRS-R score),median nerve CMAP amplitude and ulnar nerve CMAP amplitude were recorded and compared between the two groups.Results The RNS positive rate of ALS was higher than that of ulnar nerve(=45.019,P<0.001).In MG patients,the positive rate of accessory nerve RNS was higher than that of facial nerve RNS(=4.058,P=0.044);the positive rate of facial nerve RNS was higher than that of median nerve RNS(=4.340,P=0.037);the positive rate of median nerve RNS was higher than that of ulnar nerve RNS(=4.336,P=0.037).The RNS decline of the ulnar and accessory nerves in ALS patients was lower than that in MG patients(P<0.05).The CMAP amCplitude of median nerve and ulnar nerve in rNS-positive patients was lower than that in RNS-negative patients(P<0.05).onclusion The RNS decline rate of ALS patients is lower than that of MG patients,and the RNS decline rate is weakened,indicating that the condition of ALS patients is worse.Therefore,strengthening the RNS measurement is of great significance for evaluating the prognosis of ALS patients.
作者
俞周来
孙琪
谢国民
王海峰
YU Zhoulai;SUN Qi;XIE Guomin;WANG Haifeng(Ningbo Medical Center Lihuili Eastern Hospital,Ningbo 315000,China)
出处
《中国全科医学》
CAS
北大核心
2020年第S01期135-137,共3页
Chinese General Practice
关键词
肌萎缩侧索硬化
重症肌无力
重复神经刺激
应用
Amyotrophic lateral sclerosis
Myasthenia gravis
Repetitive nerve stimulation
Application
