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目的探讨A波在格林-巴利综合征(CBS)诊断中的应用价值。方法本研究回顾性分析了39例GBS患者的尺、正中、腓及胫神经在进行F波检测时的A波出现情况。结果共检测122条神经,其中有26条神经在F波检测中出现了A波,以胫神经和尺神经的A波出现率最高,分别为33.3%和30.0%,正中神经为14.3%,腓神经最低,仅为6.5%;A波出现率在上肢神经与下肢神经间的差异无统计学意义(P>0.05)。本研究患者A波类型以前位型最多见,占38.5%(10/26),多发A波次之,占30.8%(8/26),混合型A波占23.1%(6/26),最少见的是后位型A波,仅占7.7%(2/26)。39例患者巾有26例于发病1周内进行F波检测,发现有16例(61.6%)至少一条神经存在F波异常,12例(46.2%)至少一条神经出现A波,F波异常率与A波出现率间的差异无统计学意义(P>0.05),并且有7例患者虽然F波正常,却出现了A波。结论临床上当患者上肢神经出现A波时,尤其是多发A波时应引起足够重视,提示患者可能存在脱髓鞘性神经病变,A波对早期诊断GBS可能具有重要参考价值。
Objective To investigate the value of A wave in the diagnosis of Guillain-Barre syndrome (CBS). Methods This study retrospectively analyzed the A-wave appearances of the rudimental, median, peroneal, and tibial nerves of 39 patients with GBS undergoing F-wave examination. Results A total of 122 neurons were detected. Among them, 26 nerves showed A wave in F wave test, and A wave appeared in tibiofemoral nerve and ulnar nerve with the highest incidence of 33.3% and 30.0%, respectively, and median nerve was 14.3% The lowest nerve was only 6.5%. There was no significant difference in the appearance rate of A wave between upper extremity nerve and lower extremity nerve (P> 0.05). In our study, the A-wave type was the most common type before, accounting for 38.5% (10/26), followed by multiple A waves (30.8%, 8/26), mixed A wave accounting for 23.1% (6/26) Rare is the posterior A wave, accounting for only 7.7% (2/26). Twenty-six cases (39.6%) had F wave abnormalities in at least one nerve of 16 cases (61.6%), and at least one nerve in 12 cases (46.2%) had A wave and F wave abnormality rate There was no significant difference between the two groups (P> 0.05). There were 7 patients with A wave, although F wave was normal. Conclusions When A wave occurs in the upper limbs of patients, especially when multiple A waves occur, it is suggested that demyelinating neuropathy may exist in patients. A wave may be an important reference value for the early diagnosis of GBS.