早期吉兰-巴雷综合征的神经电生理特点分析

Electrophysiological characteristics in patients with early Guillain-Barre syndrome

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CBS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，且两组问F波异常比例（χ^2=8．657，P=0．003）及SCV异常率（χ^2=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。

Objective To analyze the characteristics of the F waves, H-reflex and nerve conductions and its diagnostic value in the patients with Guillaiu-Barre 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 （ χ^2= 8. 657, P = 0. 003 ） and SCV （ χ^2= 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.