急性有机磷农药中毒“中间期肌无力综合征”的诊断及分级诊断

The diagnosis and gradation of “intermediate myasthenia syndrome” following acute organophosphate poisoning

目的 探讨急性有机磷中毒中间期肌无力综合征 (IMS)的诊断及分级诊断和处理原则。方法 对 5 9例IMS进行临床研究及分析。结果 IMS多在重度急性有机磷中毒后 1～ 4d出现 ,于急性胆碱能危象消失后发现屈颈肌、颅神经支配肌肉及 (或 )呼吸肌无力。重频刺激神经 肌电图显示神经肌接头突触后传导阻滞。血淋巴细胞乙酰胆碱烟碱受体 (nAChR)特异结合活性增高。

Objectives To investigate the clinical diagnosis and gradation of “intermediate myasthenia syndrome(IMS)" following acute organophosphate poisoning.Method 59 cases of IMS were clinically investigated and analyzed.Results The myasthenia of neck flexors,cranial motor nerve innervated muscles or respiratory muscles appeared on 1st～4th day following acute organophosphate poisoning after recovery of cholinergic crisis.The repetitive nerve stimulation electromyography showed a post synaptic transmission block at the neuromuscular junctions.The specific binding of nAChR in blood lymphocytes was increased.Conclusion The authors first proposed the diagnostic criteria for mild and severe IMS and recommended the principles of treatment.