论文部分内容阅读
目的 :探讨吉兰 巴雷综合征 (GBS)中急性炎性脱髓鞘性多发性神经根神经病 (AIDP)和慢性炎性脱髓鞘性神经根神经病 (CIDP)的电生理改变特点。方法 :对 38例GBS患者进行肌电图(EMG)、神经电图及F波检测。测定运动神经传导速度 (MCV)、感觉神经传导速度 (SCV)及末端潜伏期(Lat)和波幅 (Amp) ;测定F波最短潜伏期、出现率。对比CIDP组与AIDP组患者的电生理改变特点。结果 :CIDP与AIDP中EMG去神经电位出现率分别为 81%和 5 0 % ,运动单位电位 (MUP)多相波分别为 6 9%和 37% ,大力收缩时募集相呈单纯或单混相分别为 73%和 31% ;MCV减慢分别为 6 9%和 5 4% ,Lat延长分别 5 7%和 32 % ,Amp下降或引不出分别为 5 5 %和 40 % ;SCV减慢分别为 5 7%和 19% ,Lat延长为 42 %和 19% ,Amp下降或引不出为 43%和 10 % ,上述参数在两组间比较均具有显著统计学意义。结论 :CIDP与AIDP两组EMG均表现有广泛性周围性神经源性损害的电生理特征。CIDP组EMG、MCV、SCV等参数异常改变均较AIDP显著 ,且表现为运动与感觉同时受累。AIDP患者F波异常发生率明显高于MCV异常发生率 ,F波与MCV同时检测在吉兰 巴雷综合征诊断中有着重要的互补作用。
Objective: To investigate the electrophysiological changes of acute inflammatory demyelinating multiple nerve root neuropathy (AIDP) and chronic inflammatory demyelinating nerve root neuropathy (CIDP) in Guillain-Barre syndrome (GBS). Methods: Electromyography (EMG), electrogram and F wave were detected in 38 patients with GBS. The motor nerve conduction velocity (MCV), sensory nerve conduction velocity (SCV) and terminal latencies (Lat) and amplitude (Amp) were measured. The shortest incubation period and frequency of F wave were determined. Electrophysiological changes in patients with CIDP and AIDP were compared. Results: The incidences of EMG denervation in CIDP and AIDP were 81% and 50%, respectively. The MUP polyphasic waves were 69% and 37%, respectively. Were 73% and 31% respectively; MCV slowed down to 69% and 54% respectively; Lat extended 57% and 32% respectively; Amp decreased or dipped to 55% and 40%, respectively; 5 7% and 19%, Lat extended to 42% and 19%, Amp decreased or cited 43% and 10%, the above parameters between the two groups were statistically significant. Conclusion: EMG in both CIDP and AIDP groups showed electrophysiological characteristics of extensive peripheral neurogenic lesions. The abnormal changes of EMG, MCV, SCV and other parameters in CIDP group were more significant than those in AIDP, and the motor and sensory involvement manifested at the same time. The incidence of F wave abnormalities in patients with AIDP is significantly higher than that of MCV abnormalities. Simultaneous detection of F wave and MCV plays an important complementary role in the diagnosis of Guillain-Barre syndrome.