重症肌无力重复神经电刺激检测的比较研究

目的比较肘肌、三角肌、小指展肌重复神经电刺激（RNS）对重症肌无力（MG）的诊断价值。方法应用低频RNS技术对18例MG患者的肘肌、三角肌、小指展肌进行疲劳前后的检测，用DANTECounterpoint肌电图仪记录。结果对照组肘肌、三角肌、小指展肌疲劳前RNS电压分别降低了1．54％±1．32％、1．64％±1．43％、0．62％±0．38％；疲劳后RNS电压分别降低了2．01％±1．75％、2．05％±1．98％、1．02％±0．75％。MG组肘肌、三角肌、小指展肌疲劳前测试阳性分别为9／18（50％）、10／18（55．6％）、3／18（16．7％）（P均＜0．05）；疲劳后RNS测试阳性分别为15／18（83．3％）、14／18（77．8％）、6／18（33．3％）（P均＜0．05）。经卡方检验，肘肌疲劳前后RNS测试阳性率有显著性差异（P＜0．05）。小指展肌、三角肌疲劳前后RNS测试阳性率对比无显著性差异。结论MG患者肘肌疲劳后RNS阳性率较疲劳前明显增高，而三角肌、小指展肌疲劳前后RNS阳性率无显著性差异；肘肌、三角肌RNS测试较小指展肌更敏感，但肘肌RNS方法简便，病人不适程度轻，有较大的临床实用价值。

A comparison of repetitve nerve stimulation in diagnosis of myasthenia gravis

] Objective To compare repetitive nerve stimulation (RNS) of anconeus muscle,triangular muscle and abductor digitiminimi(ADM) muscle in diagnosis of myasthenia gravis(MG). Methods Before or after efforts, anconeus, triangular and ADM muscleRNS were conducted on 18 patients with MG. Results All of the control subjects were negative (amplitude reduce< 15% )before or afterefforts with , triangular and ADM muscle RNS. In the MG group, positive rates of anconeus, triangular and ADM muscle RNS wereindividually 9/18(50% ), 10/18(55. 6% ), 3/18 (16. 7% ) before efforts and 15/18(83. 3% ), 14/18(77. 8% ), 6/18 (33. 3% ) afterefforts. There was a significant difference in the same nerve RNS before and after efforts(P < 0.05). There was no significant difference inpositive rates of RNS between abductor digiti minimi and triangual muscle before or after efforts. Conclusion In the MG group, positiverates of anconeus muscle RNS after efforts were higher than those before efforts;anconeus, triangual muscle RNS was more sensitive thanthat d ADM muscle. Anconeus RNS is a simple, sensitive and practicable method for diagnosis MG or estimation of neuromuscularfunction.