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目的探讨声反射检查在重症肌无力患者诊断及病情监测方面的应用价值。方法对以头颈部和五官症状为首发症状而到我科初诊的16例重症肌无力患者进行纯音测听和声导抗检测,并在肌肉注射甲基硫酸新斯的明0.5~1.0 mg,30 min后复查声反射。检测用0.5、1.0、2.0和4.0 kHz的纯音作同侧和对侧刺激,比较用药前后有无声反射及其阈值、振幅变化、有无衰减等。结果13例患者声反射4项指标中至少有1项改善,判为阳性,阳性率高达81.3%。余3例患者声反射4项指标均无改善,为阴性。结论声反射检测具有敏感、使用方便等优点,是一种客观、可靠、无创伤的检查方法,在重症肌无力的诊断及病情监测方面有一定的应用价值。
Objective To investigate the value of acoustic reflex in the diagnosis and condition monitoring of patients with myasthenia gravis. Methods Totally 16 patients with myasthenia gravis diagnosed with head and neck and facial features as the first symptom were examined with pure tone audiometry and acoustic impedance. Intramuscular injection of neostigmine methylsulfate 0.5 ~ 1.0 mg, Reflex after 30 min reflex. Detection of pure tone 0.5,1.0,2.0 and 4.0 kHz for ipsilateral and contralateral stimulation, before and after treatment compared with the silent reflection and threshold, amplitude changes, with or without attenuation. Results At least one of the four indexes of acoustic reflex of 13 patients was improved, which was judged as positive and the positive rate was as high as 81.3%. The remaining three patients had no improvement in all four indexes of acoustic reflex, which was negative. Conclusion Acoustic reflex detection is sensitive, easy to use and so on. It is an objective, reliable and noninvasive method for the detection of myasthenia gravis. It has certain value in diagnosis and condition monitoring of myasthenia gravis.