摘要
目的 :探讨吉兰 巴雷综合征 (GBS)中急性炎性脱髓鞘性多发性神经根神经病 (AIDP)和慢性炎性脱髓鞘性神经根神经病 (CIDP)的电生理改变特点。方法 :对 38例GBS患者进行肌电图(EMG)、神经电图及F波检测。测定运动神经传导速度 (MCV)、感觉神经传导速度 (SCV)及末端潜伏期(Lat)和波幅 (Amp) ;测定F波最短潜伏期、出现率。对比CIDP组与AIDP组患者的电生理改变特点。结果 :CIDP与AIDP中EMG去神经电位出现率分别为 81%和 5 0 % ,运动单位电位 (MUP)多相波分别为 6 9%和 37% ,大力收缩时募集相呈单纯或单混相分别为 73%和 31% ;MCV减慢分别为 6 9%和 5 4% ,Lat延长分别 5 7%和 32 % ,Amp下降或引不出分别为 5 5 %和 40 % ;SCV减慢分别为 5 7%和 19% ,Lat延长为 42 %和 19% ,Amp下降或引不出为 43%和 10 % ,上述参数在两组间比较均具有显著统计学意义。结论 :CIDP与AIDP两组EMG均表现有广泛性周围性神经源性损害的电生理特征。CIDP组EMG、MCV、SCV等参数异常改变均较AIDP显著 ,且表现为运动与感觉同时受累。AIDP患者F波异常发生率明显高于MCV异常发生率 ,F波与MCV同时检测在吉兰 巴雷综合征诊断中有着重要的互补作用。
Objective:To investigate the electroneuromyographical characters of acute inflammatory demyelinating polyradiculoneuropathy(AIDP) and chronic inflammatory demyelinating polyradiculoneuropathy(CIDP) of Guillain barre syndrome(GBS).Methods: Motor conduction velocity(MCV),sensory conduction velocity(SCV), distal latency(Lat) and distal amplitude (Amp) were measured as well as the shortest latency and the detection rate of F wave. The characters and extent of abnormal electrophysiological changes in patients with AIDP and CIDP then were compared with each other.Results:The occurrence rate of spontaneous potentials of electromyogram(EMG) was 81% and 50%,motor unit potential(MUP) polyphase waves were 69% and 37%,recruitment phase in ballistic contraction were 73% and 31% respectively on CIPD and AIPD patients(P<0 001,respectively).Slowing MCV were 64% and 54%, prolonged Lat were 57% and 32%,dropped or inactituated Amp were 55% and 40%, prolonged lat of F waves were 47% and 39%,inactituated F waves were 21% and 16% respectively in CIPD and AIDP patients(P<0.05 respectively).Conclusion:Electrophysiological changes of AIDP and 1 AIDP are analogous. Extensive involvement of the peripheral nerves was found in their EMG. Both the sensory and motor components were involved in CIDP.The abnormal changes of parameters of EMG, MCV and SCV were more serious in CIDP than in AIDP. In AIDP, the occurrence rate of abnormal F waves might be much helpful for each other in diagnosing GBS.
