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早期吉兰-巴雷综合征的神经电生理特点分析
引用本文:潘涛,贾志荣,王亭亭,王洪霞,石昕,梁为.早期吉兰-巴雷综合征的神经电生理特点分析[J].中华神经科杂志,2011,44(11).
作者姓名:潘涛  贾志荣  王亭亭  王洪霞  石昕  梁为
作者单位:100034,北京大学第一医院神经内科
摘    要:目的 分析发病4周内吉兰-巴雷综合征(GBS)患者的F波、H反射及神经传导的改变特点,探讨F波及H反射检查在早期GBS中的诊断价值.方法 回顾性分析我院40例确诊GBS患者的神经电生理资料特点,依据病程分为2组(≤2周组及>2周组).使用卡方检验,分别对两组患者的F波、H反射、运动神经传导速度(MCV)和感觉神经传导速度(SCV)检测的异常率进行分析.结果 病程≤2周组及>2周组F波异常比例分别为17/20、7/18,H反射的异常比例分别为13/20、12/19,MCV异常率为28.4%(25/88)、32.9%(26/79),运动神经传导远端潜伏期异常率为40.9%(36/88)、36.7%(29/79),复合肌肉动作电位波幅异常率为35.2%(31/88)、32.9%(26/79),SCV异常率为11.2%(10/89)、25.2%(24/95).两组患者中F波、H反射异常率均较高,且两组间F波异常比例(X2 =8.657,P=0.003)及SCV异常率(x2 =6.002,P=0.014)差异具有统计学意义.结论 F波及H反射对GBS的早期诊断具有一定的诊断参考价值;神经电生理检查对GBS具有重要诊断价值.

关 键 词:格林·巴利综合征  电生理学  H反射  神经传导

Electrophysiological characteristics in patients with early Guillain-Barré syndrome
PAN Tao,JIA Zhi-rong,WANG Ting-ting,WANG Hong-xia,SHI Xin,LIANG Wei.Electrophysiological characteristics in patients with early Guillain-Barré syndrome[J].Chinese Journal of Neurology,2011,44(11).
Authors:PAN Tao  JIA Zhi-rong  WANG Ting-ting  WANG Hong-xia  SHI Xin  LIANG Wei
Abstract:Objective To analyze the characteristics of the F waves,H-reflex and nerve conductions and its diagnostic value in the patients with Guillain-Barré syndrome(GBS)onset within 4 weeks.Methods The electrophysiological data of the 40 patients with GBS were analyzed retrospectively.These patients were divided into 2 groups according to the duration of illness including in 2 week' s group and over 2 week' s group.The results of the F waves,H-reflex,the motor nerve conduction velocity (MCV),and the sensory nerve conduction velocity(SCV)of these patients were analyzed.Results The abnormality rate of the F waves was 17/20 and 7/18 respectively in less 2 week' s group and over 2 week' s.The H-reflexes were 13/20 and 12/19.The MCV was 28.4%(25/88)and 32.9%(26/79).The distal motor latency was 40.9%(36/88)and 36.7%(29/79).The compound muscle action potential amplitude was 35.2%(31/88)and 32.9%(26/79)respectively in these two groups.The abnormality rate of the SCV was 11.2%(10/89)and 25.2%(24/95)respectively in the two groups.The higher abnormality rate of these tests was the F waves and H-reflex in both the groups.The abnormality rates of the F waves(x2 =8.657,P =0.003)and SCV(x2 =6.002,P =0.014)were significantly different between the two groups.There were no significant differences in the other tests.Conclusion The electrophysiological tests are valuable in the diagnosis of GBS.The F waves and H-reflex are more significant for early diagnosis of GBS.
Keywords:Guillain-Barré syndrome  Electrophysiology  H-reflex  Neural conduction
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