神经电生理检测在吉兰-巴雷综合征中的临床价值

Clinical value of neuro-electrophysiological measure in Guillaln-Barre syndrome

目的探讨吉兰-巴雷综合征（GBS）的神经电生理特点及临床意义。方法对本院46例GBS患者的临床资料进行回顾性分析，分析患者神经功能损伤的Hughes评分和神经电生理检查的运动神经传导速度、复合肌肉动作电位、感觉神经传导速度及F波的变化，探讨其与GBS预后的关系。结果F波异常率[74．6％（47／63）]高于运动神经传导速度异常率[58．9％（106／180）]，感觉神经传导速度异常率[19．8％（19／96）]低于运动神经传导速度异常率[58．9％（106／180）]和F波异常率[74．6％（47／63）]（P〈0．05）；急性炎症性脱髓鞘型组的预后[80％（24／30）]好于急性运动轴索性神经病组[50％（8／16）]，其差异比较有统计学意义（P〈0．05）。结论电生理检查是GBS临床诊断的重要方法，F波是早期诊断的高敏感和高特异性指标，运动神经传导速度和复合肌肉动作电位动态检测是确诊、分型、判断预后的依据。

Objective To explore the characteristics of neuro-electrophysiology and clinical value in patients with Guillain-Barre syndrome. Metheds We performed retrospective analysis of the clinical date of 46 patients with Guillain-Barre syndrome in our hospital. Hughes grades and neuro-electrophysiologi- cal measure including motor conduction velocity （MCV）, complex muscle action potential （CMAP）, sensory conduction velocity （SCV） and F wave, were investigated as the related factors with the prognosis of GBS. Results The rate of abnormal F wave was higher than the rate of abnormal MCV. The rate of abnormal SCV was lower than the rate of abnormal F wave and MCV（ P 〈0. 05）. The prognosis of the acute inflam- matory demyelinating polyneuropathy （AIDP） group was superior to the acute motor axonal neuropathy （AMAN） group, and there had significant difference （ P 〈 0.05 ）. Conclusions The neuro-electrophysio- logical investigation is an important way to diagnose the GBS. F wave is a sensitive and specify index in the early diagnosis of GBS. The neuro-electrophysiological observation of MCV and CMAP may be served as cues for diagnosis, determination of the subtype and evaluation of the treatment effect in GBS.