斜方肌肌电图运动单位动作电位成人正常参考值的建立

目的 探讨不同血清抗体重症肌无力(MG)的临床特征.方法 用荧光免疫沉淀法(FIPA)和荧光免疫细胞染色法(CBA)检测119例MG患者血清乙酰胆碱受体抗体(AChR-Ab)和肌肉特异性受体酪氨酸激酶抗体(MuSK-Ab)水平.比较AChR-Ab阳性、MuSK-Ab阳性、血清抗体阴性MG的临床特征.结果 纳入119例患者中,90例AChR-Ab阳性(75.6%),29例阴性:其中5例MuSK-Ab阳性(17.2%),24例血清抗体阴性(82.8%).AChR-Ab阳性、MuSK-Ab阳性和血清抗体阴性MG 3组比较,男女比例和平均发病年龄差异均无统计学意义.3例MuSK-Ab阳性的患者主要表现为延髓肌受累;79.2%(19/24)的血清抗体阴性MG患者表现为美国MG协会(MGFA)Ⅰ型;2例MuSK-Ab阳性的患者MGFA≥Ⅲ型;MuSK-Ab滴度水平与患者病情严重程度相关(r=0.941,P=0.014);MuSK-Ab阳性的患者均未发现有胸腺的异常.结论 MuSK-Ab仅出现在AChR-Ab阴性患者的血清中.MuSK-Ab阳性的患者主要表现为延髓肌受累,病情较重且不伴有胸腺的病变.MuSK-Ab阳性的MG可能是不同于血清AChR-Ab阳性的MG的又一亚型.

Normative value of motor unit action potential of trapezius electromyography in adult

Objective To assess the normative value of motor unit action potential of trapezius electromyography(EMG)and the amplitude of compound muscle action potential(CMAP)of accessory nerve.Methods Standard EMG and CMAP of accessory nerve were recorded from upper trapezius muscle in 100 healthy volunteers.For accessory nerve,it was stimulated in the upper sternocleidomastoid muscle and was recorded in the junction of the neck and shoulder.For trapezius EMG,it was recorded also in the junction of the neck and shoulder,includiag spontaneous activity,motor unit action potential and recruitment pattern.Results The amplitude,duration,polyphasic wave of motor unit action potential was(610.7±79.2)μV,(11.2±1.5)ms,(11.7±1.2)% respectively.The amplitude of compound muscle action potential of accessory nerve was(8.7±2.3)mV.Conclusion The electromyography of trapezius and CMAP of accessory nerve can be examined accurately.