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目的探讨神经电生理检查对危重病性神经肌病的诊断意义。方法选取2015年1月~2016年12月我院收治的30例确诊为危重病性神经肌病患者设置为观察组,再在同时间段内选取50例体检正常者作为对照组,两组受检者均接受神经电生理检查,并对其运动神经和感觉神经电生理检查结果进行分析和比较,计算神经电生理检查对危重病性神经肌病的诊断符合情况。结果运动神经电生理检查结果显示,观察组正中神经、尺神经的运动神经传导速度、诱发电位振幅均明显低于对照组(P<0.05),其运动神经诱发电位远端潜伏期明显延长(P<0.05);感觉神经电生理检查结果显示,观察组正中神经、尺神经的感觉神经传导速度、诱发电位振幅均明显低于对照组(P<0.05);神经电生理检查对危重病性神经肌病的诊断敏感性、特异性、准确性、阳性预测值、阴性预测值分别为96.67%、96.00%、96.25%、93.55%、97.96%,与确诊结果之间的一致性良好(Kappa=0.724)。结论神经电生理检查对危重病性神经肌病进行诊断的准确性较高,可反映危重病性神经肌病的神经损伤情况。
Objective To investigate the significance of neuroelectrophysiology in the diagnosis of critical neuropathy. Methods From January 2015 to December 2016, 30 cases of critically ill patients with neuromuscular diseases admitted to our hospital were enrolled in the observation group. Fifty cases of normal subjects were selected as the control group during the same period. All the patients underwent neuroelectrophysiological examination. The results of electrophysiological examination of motor and sensory nerves were analyzed and compared, and the diagnostic value of neuroelectrophysiological examination for critical neuromuscular disease was calculated. Results Motor nerve electrophysiological examination showed that the motor nerve conduction velocity and evoked potential amplitude of the median nerve and ulnar nerve in the observation group were significantly lower than those in the control group (P <0.05), and the latency of the motor nerve evoked potentials was significantly prolonged (P < 0.05). The results of sensory nerve electrophysiological examination showed that the sensory nerve conduction velocity and evoked potential amplitude of the median nerve and ulnar nerve in the observation group were significantly lower than those in the control group (P <0.05); neurophysiological examination showed no significant difference in the severity of neuropathy The diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value were 96.67%, 96.00%, 96.25%, 93.55% and 97.96%, respectively, which were consistent with the diagnostic results (Kappa = 0.724). Conclusion The neuroelectrophysiological examination has a high accuracy in the diagnosis of critical neuromuscular diseases and can reflect the neurological damage of critical neuromuscular diseases.