运动单位数目估计在特发性面神经麻痹病情评估及预后的应用

Application of motor unit number estimation in evaluation and prognosis of idiopathic facial paralysis

目的探讨运动单位数目估计的方法评估特发性面神经麻痹患者的病情及预后的应用效果。方法选取2018-01—2019-01大连市中心医院40例特发性面神经麻痹患者为研究对象,于发病第3天、第14天、1个月、3个月、6个月行面神经动作波幅、面神经运动单位数目估计检查,并与健侧对比;并统计多伦多面神经功能评分(TFGS),了解患者预后情况。结果40例患者患侧发病后第3天、第14天、1个月、3个月、6个月运动单位数目估计(motor unit number estimation,MUNE)分别为(143±45)个、(142±44)个、(142±45)个、(197±45)个、(265±67)个,其与健侧比较差异均有统计学意义(P<0.05);40例患者在发病后第3天、第14天、1个月、3个月面神经运动波幅分别为(3.4±0.6)mv、(3.6±0.6)mv、(3.0±0.6)mv、(5.6±0.8)mv,其与健侧比较差异均具有统计学意义(P<0.05),在6月时患侧面神经运动波幅为(6.4±0.8)mv,与健侧差异无统计学意义(P>0.05);40例患者按TFGS评分进行组间比较,发现MUNE在发病后第3天、第14天、1个月、3个月与健侧差异均具有统计学意义(P<0.05),而面神经运动波幅与健侧比较差异无统计学意义(P>0.05)。结论运动单位数目估计检查应用于特发性面神经麻痹患者,可以反映病情的严重程度,并能在一定程度上评估预后。

Objective To Evaluate the condition and prognosis of patients with idiopathic facial paralysis by motor unit number estimation(MUNE).Methods Forty patients with idiopathic facial paralysis in our hospital from January 2018 to January 2019 were selected.The amplitude of facial nerve complex muscle action and MUNE were measured on the 3rd day,14th day,1st month,3rd month and 6th month after the onset of the disease,and compared with the healthy side.TFGS was counted to observe the prognosis of the patients.Results The MUNE of 40 patients on the third day,the 14th day,the first month,the third month and the sixth month after onset were 143±45,142±44,142±45,197±45 and 265±67,respectively,which was statistically significant compared with the healthy side(P<0.05).On the 3rd day,14th day,1 month and 3 months after onset,the amplitude of facial nerve movement in 40 patients were(3.4±0.6)mV,(3.6±0.6)mV,(3.0±0.6)mV and(5.6±0.8)mV respectively,which was statistically significant compared with the healthy side(P<0.05).At 6 months,the amplitude of facial nerve movement in the affected side was(6.4±0.8)mV,which was not statistically significant compared with the healthy side(P>0.05).The 40 patients were grouped according to TFGS score,there were statistically significant differences on MUNE on the 3rd day,14th day,1 month,and 3 months after the onset of the disease compared with the healthy side(P<0.05),while the facial nerve motor amplitude was not statistically significant compared with the healthy side(P>0.05).Conclusion MUNE can reflect the severity of the disease and evaluate the prognosis to a certain extent.