以复视为首发症状的重症肌无力患者改良新斯的明试验的判断及研究

Judgment and research of modified neostigmine test in myasthenia gravis with diplopia as initial symptoms

目的针对首发症状仅表现为复视的重症肌无力(MG)患者,改良原有新斯的明试验方法,为提高这类患者诊断准确率及减少误诊提供参考。方法收集首发症状表现为复视的MG患者32例,疾病对照组10例,对受试者均进行经典新斯的明和改良新斯的明试验检测,并对结果进行统计分析。结果 (1)9例MG患者经典新斯的明试验结果为阳性(28%,9/32),26例MG患者改良新斯的明试验结果为阳性(81%,26/32);(2)疾病对照组在两种试验中阳性率均为0(0,0/10)。结论改良新斯的明试验对以复视为首发症状的MG患者辅助诊断价值较高,辅助诊断MG有一定临床意义。

Objective To raise the diagnosis rate of accuracy and reduce the misdiagnosis rate, we modified the originalneostigmine test to myasthenia gravis （ MG） with diplopia as initial symptoms. Methods 32 MG patients with theprimary symptom of diplopia, 10 patients with other diseases were collected in the study. All participants were analyzed byclassic neostigmine test and modified neostigmine test. Results （1 ）9 MG patients were positive in traditional neostigminetest（28% ,9/32）. 26 MG patients were positive in modified neostigmine test（81% ,26/32）. （2 ） The positive rate of thedisease control group was 0 （0 , 0 /10 ）. Conclusion Modified neostigmine test may be a valuable supplementary diagnosticmethod for MG patients with diplopia as initial symptoms.