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目的:对重症肌无力(MG)患者行低频重复神经电刺激(RNS)检测中的疲劳试验,阐明疲劳试验对MG患者的诊断价值。方法:收集30例MG患者,对面神经进行静息状态低频RNS检测,并进行疲劳试验,分别疲劳1和2min,在疲劳结束后的即刻、休息1min及2min再进行RNS检测。分析静息及疲劳后不同时间点RNS中复合肌肉动作电位(CMAP)波幅递减百分率的差异。结果:低频RNS疲劳试验各时间点CMAP波幅递减幅度均较静息状态递减幅度明显,30例患者中以疲劳2min后休息1min RNS递减幅度最明显。30例患者中12例患者RNS静息状态下CMAP波幅未见明显递减现象,而疲劳后CMAP波幅递减明显。结论:低频RNS疲劳试验可明显提高MG患者的诊断率,尤其对于静息状态下RNS检测正常的MG患者有效。检测时以疲劳2min后休息1min效果最明显。
OBJECTIVE: To evaluate the fatigue test of low frequency repeated electrical nerve stimulation (RNS) in patients with myasthenia gravis (MG) and to elucidate the diagnostic value of fatigue test in patients with MG. Methods: Thirty patients with MG were collected. The facial nerve was examined by low frequency RNS at resting state and fatigue test was performed for 1 and 2 minutes respectively. RNS was performed at 1 minute and 2 minutes after the end of fatigue. The difference of the percentage decrease of amplitude of compound muscle action potential (CMAP) in RNS at rest and after fatigue was analyzed. Results: In the low-frequency RNS fatigue test, the decreasing amplitude of CMAP amplitude at each time point was significantly lower than that of resting state. In 30 patients, the decreasing range of RNS was the most obvious after resting for 2min at 1min after fatigue. There was no significant decrease of CMAP amplitude in resting state of RNS in 12 patients of 30 patients, while the amplitude of CMAP decreased significantly after fatigue. Conclusion: The low-frequency RNS fatigue test can significantly improve the diagnostic rate of MG patients, especially for patients with MG with normal RNS in resting state. Detection of fatigue 2min rest after 1min the most obvious effect.