单纤维肌电图结合疲劳试验对重症肌无力的诊断价值

摘要

目的 对重症肌无力(MG)患者行单纤维肌电图(SFEMG)检测及疲劳试验,探讨两者结合对重症肌无力的诊断意义.方法 选择53例MG患者进行试验.均在下午15点~16点选取小指展肌、三角肌进行SFEMG检测,休息10min后,进行疲劳试验5min,休息2min后再进行SFEMG检测记录相关数据进行分析.结果 53例患者中,单纯SFEMG检查正常者20例(33.73%),异常者33例(62.26%),其中颤抖延长者有34例(64.15%),阻滞者28例(52.83%).疲劳试验后,SFEMG检查正常者3例(5.66%),异常者50例(94.34%),其中颤抖延长者有48例(90.57%),阻滞者43例(81.13%).疲劳试验前后两者数据相比,差异有统计学意义(P<0.05).结论 SFEMG结合疲劳试验可明显提高MG患者的阳性诊断率,尤其对于静息状态下SFEMG检测正常的MG患者更有效,能在检测中很好的减少伪差,减小患者重复检查的痛苦,并对记录结果的分析有很高的参考价值.%Objective To study the value of single fiber electromyography(SFEMG)and fatigue testing in diagnosis of the myasthenia gravis(MG)patients. Method Fifty-three patients with MG were selected to carry out the experiment. SFEMG was performed in the little finger abductor muscle and deltoid of all selected cases at the same time period in the afternoon. After a break of 10 minutes, the cases were conducted the fatigue test for 5 minutes. And two minutes later, SFEMG detection was performed again. The data was recorded for analysis. Results In fifty-three cases, the result of the initial SFEMG examination showed twenty cases were normal, accounting for 33.73%, while thirty-three cases were abnormal, accounting for 62.26%. And thirty-four cases displayed trembling extension, accounting for 64. 15 %, while twenty-eight cases showed the block, accounting for 52. 83 %.After the fatigue test, the following SFEMG examination indicated 3 cases was normal, accounting for 5.66%, while fifty cases were abnormal, accounting for 94.34%. And forty-eight cases displayed trembling extension, accounting for 90.57%, while forty-three cases showed the block, accounting for 81.13 %.To compare the data before and after the fatigue test, it may have a statistical significance(P<0.05). Conclusion The combination of SFEMG and fatigue test can significantly improve the positive diagnostic rate of MG patients, especially more effective for MG patients who showed normal result of SFEMG in a resting state. This can reduce detection artifact and the suffering of repetitive inspections. The analysis of the record data show a high reference value.