本文關(guān)鍵詞： 重癥肌無力 眼瞼下垂 復(fù)視 冰試驗(yàn)(非Me SH詞) 新斯的明 肌電描記術(shù)　出處：《中國現(xiàn)代神經(jīng)疾病雜志》2016年10期 　論文類型：期刊論文

【摘要】：目的比較冰試驗(yàn)、新斯的明試驗(yàn)、單纖維肌電圖(SFEMG)診斷眼肌型重癥肌無力的敏感性和特異性,以期建立益于臨床開展的診斷流程。方法共116例新發(fā)眼瞼下垂和(或)復(fù)視患者,進(jìn)行冰試驗(yàn)、新斯的明試驗(yàn)和SFEMG,經(jīng)隨訪6個(gè)月觀察病情變化和試驗(yàn)性治療效果而最終明確診斷。結(jié)果剔除最終診斷不明、失訪和隨訪期間進(jìn)展為全身型重癥肌無力的患者,最終納入81例患者[包括眼肌型重癥肌無力21例和其他疾病引起的眼瞼下垂和(或)復(fù)視60例],冰試驗(yàn)診斷眼肌型重癥肌無力的靈敏度為95.24%(20/21)、特異度為98.33%(59/60),新斯的明試驗(yàn)分別為90.48%(19/21)和85%(51/60),SFEMG分別為95.24%(20/21)和80%(48/60),3種診斷方法僅特異性差異有統(tǒng)計(jì)學(xué)意義(χ2=5.232,P=0.022),且冰試驗(yàn)的特異度高于新斯的明試驗(yàn)(χ2=5.707,P=0.017)和SFEMG(χ2=6.023,P=0.014)。結(jié)論冰試驗(yàn)診斷眼肌型重癥肌無力的敏感性和特異性均較高,結(jié)合新斯的明試驗(yàn)和SFEMG對(duì)眼肌型重癥肌無力的早期診斷具有重要臨床意義。
[Abstract]:Objective to compare the sensitivity and specificity of ice test, neostigmine test and SFEMG in the diagnosis of myasthenia gravis. Methods 116 newly diagnosed patients with blepharoptosis and / or diplopia underwent ice test, neostigmine test and SFEMG. After 6 months of follow-up, the final diagnosis was determined by observing the state of illness and the effect of experimental treatment. Results the final diagnosis was excluded from the patients with generalized myasthenia gravis, who had lost their diagnosis and developed into systemic myasthenia gravis during the follow-up period, and 81 patients were included. [Including 21 cases of myasthenia gravis and 60 cases of blepharoptosis and / or diplopia caused by other diseases, the sensitivity of ice test in the diagnosis of myasthenia gravis was 95.2420 / 21). The specificity was 98.33 / 59 / 60, and the neostigmine test was 90.48 / 21 and 8551 / 60, respectively. The specificity of SFEMG was 95.24 / 21 and 80 / 48 / 60 / 21 respectively (蠂 ~ (2 + 2) = 5.232) (蠂 ~ (2 +) = 5.232P ~ (0.022)), and there was only a significant difference in the specificity of the three diagnostic methods (蠂 ~ (2) = 5.232). The specificity of ice test was higher than that of neostigmine test (蠂 2 + 5.707) and SFEMG (蠂 2 + 6.023). Conclusion Ice test has high sensitivity and specificity in the diagnosis of myasthenia gravis. Combination of neostigmine test and SFEMG has important clinical significance for early diagnosis of myasthenia gravis.
【作者單位】： 內(nèi)蒙古自治區(qū)包頭市中心醫(yī)院神經(jīng)內(nèi)科;內(nèi)蒙古自治區(qū)包頭市中心醫(yī)院眼科;
【分類號(hào)】：R746.1
【正文快照】： 重癥肌無力(MG)是抗乙酰膽堿受體(ACh R)抗體介導(dǎo)的、細(xì)胞免疫依賴性和補(bǔ)體參與的自身免疫性疾病。臨床特點(diǎn)主要是隨意肌易疲勞性和癥狀波動(dòng)性,呈現(xiàn)晨輕暮重、休息后減輕。眼肌型重癥肌無力(OMG)是重癥肌無力的常見類型,主要局限于眼部周圍肌肉受累,包括眼外肌、提上瞼肌、眼

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