眼肌型重症肌无力辅助诊断方法对比研究

发布时间：2018-01-22 04:04

本文关键词： 重症肌无力眼睑下垂复视冰试验(非Me SH词) 新斯的明肌电描记术　出处：《中国现代神经疾病杂志》2016年10期 　论文类型：期刊论文

【摘要】：目的比较冰试验、新斯的明试验、单纤维肌电图(SFEMG)诊断眼肌型重症肌无力的敏感性和特异性,以期建立益于临床开展的诊断流程。方法共116例新发眼睑下垂和(或)复视患者,进行冰试验、新斯的明试验和SFEMG,经随访6个月观察病情变化和试验性治疗效果而最终明确诊断。结果剔除最终诊断不明、失访和随访期间进展为全身型重症肌无力的患者,最终纳入81例患者[包括眼肌型重症肌无力21例和其他疾病引起的眼睑下垂和(或)复视60例],冰试验诊断眼肌型重症肌无力的灵敏度为95.24%(20/21)、特异度为98.33%(59/60),新斯的明试验分别为90.48%(19/21)和85%(51/60),SFEMG分别为95.24%(20/21)和80%(48/60),3种诊断方法仅特异性差异有统计学意义(χ2=5.232,P=0.022),且冰试验的特异度高于新斯的明试验(χ2=5.707,P=0.017)和SFEMG(χ2=6.023,P=0.014)。结论冰试验诊断眼肌型重症肌无力的敏感性和特异性均较高,结合新斯的明试验和SFEMG对眼肌型重症肌无力的早期诊断具有重要临床意义。
[Abstract]:Objective to compare the sensitivity and specificity of ice test, neostigmine test and SFEMG in the diagnosis of myasthenia gravis. Methods 116 newly diagnosed patients with blepharoptosis and / or diplopia underwent ice test, neostigmine test and SFEMG. After 6 months of follow-up, the final diagnosis was determined by observing the state of illness and the effect of experimental treatment. Results the final diagnosis was excluded from the patients with generalized myasthenia gravis, who had lost their diagnosis and developed into systemic myasthenia gravis during the follow-up period, and 81 patients were included. [Including 21 cases of myasthenia gravis and 60 cases of blepharoptosis and / or diplopia caused by other diseases, the sensitivity of ice test in the diagnosis of myasthenia gravis was 95.2420 / 21). The specificity was 98.33 / 59 / 60, and the neostigmine test was 90.48 / 21 and 8551 / 60, respectively. The specificity of SFEMG was 95.24 / 21 and 80 / 48 / 60 / 21 respectively (蠂 ~ (2 + 2) = 5.232) (蠂 ~ (2 +) = 5.232P ~ (0.022)), and there was only a significant difference in the specificity of the three diagnostic methods (蠂 ~ (2) = 5.232). The specificity of ice test was higher than that of neostigmine test (蠂 2 + 5.707) and SFEMG (蠂 2 + 6.023). Conclusion Ice test has high sensitivity and specificity in the diagnosis of myasthenia gravis. Combination of neostigmine test and SFEMG has important clinical significance for early diagnosis of myasthenia gravis.
【作者单位】：内蒙古自治区包头市中心医院神经内科;内蒙古自治区包头市中心医院眼科;
【分类号】：R746.1
【正文快照】： 重症肌无力(MG)是抗乙酰胆碱受体(ACh R)抗体介导的、细胞免疫依赖性和补体参与的自身免疫性疾病。临床特点主要是随意肌易疲劳性和症状波动性,呈现晨轻暮重、休息后减轻。眼肌型重症肌无力(OMG)是重症肌无力的常见类型,主要局限于眼部周围肌肉受累,包括眼外肌、提上睑肌、眼

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