肌萎缩侧索硬化与颈椎病鉴别诊断方法的评估

目的 探讨早期肌萎缩侧索硬化（ＡＬＳ）与颈椎病鉴别诊断的临床首选方法。方法 对临床已确诊的５３例ＡＬＳ，１４例脊髓型颈椎病（ＣＳＭ），２３例神经根型颈椎病（ＣＳＲ）患者的临床症状／体征和肌电图异常特征进行百分比统计及其比值比分析，对依据高比值比的临床症状／体征组合与肌电图所作出的鉴别诊断的可行性作比较。结果 以高比值比的临床症状／体征组合实施多步鉴别诊断的真阳性率９８％，真阴性率８６．５％，单凭肌电图难以作出鉴别诊断。结论 高比值比的临床症状／体征组合是ＡＬＳ与ＣＳＭ和ＣＳＲ鉴别诊断的首选临床方法。

An evaluation on the method of the differential diagnosis between amyotrophic lateral sclerosis and cervical spondylosis

Objective To investigate clinical first selected method on the differential diagnosis at early stage between amyotrophic lateral sclerosis(ALS) and cervical spondylosis.Methods The clinical features and EMG in 53 patients with ALS,14 patients with cervical spondylotic myelopathy(CSM) and 23 patients with cervical spondylotic radiculopathy(CSR) were analysed.And then the value of ratio of every probability was calculated.According to the value of ratio, the clinical features and EMG were compared in differential dia gnosis.Results A multiprogram that consisted of high multiple clinical features was used in differential diagnosis, true positive rate is 98%, and true negative rate is 86.5%,EMG still couldn't be used in the differential diagnosis.Conclusion The program is the first selected method, which can be used in the differential diagnosis between ALS and CSM/CSR.