远端复合肌肉动作电位时限在慢性炎性脱髓鞘性多发性神经病中的应用

Application of distal compound muscle action potential duration in chronic inflammatory demyelinating polyneuropathy

目的探讨远端复合肌肉动作电位时限(DCMAPD)对协助诊断慢性炎性脱髓鞘性多发性神经病(CIDP)的价值。方法选取2017年8月至2022年8月湖南省脑科医院收治的明确诊断CIDP的患者28例作为CIDP组,选取30位健康志愿者作为对照组,检测两组受试者的正中神经、尺神经、胫神经及腓总神经的DCMAPD,并分析比较两组间DCMAPD的差异。同时应用受试者工作特征曲线(ROC)分析各神经DCMAPD在CIDP诊断中的价值,并进一步分析DCMAPD的最佳临界值。结果与对照组比较,CIDP组的正中神经、尺神经、胫神经及腓总神经的DCMAPD明显延长(P均<0.001)。ROC曲线分析显示正中神经、尺神经、胫神经和腓总神经各运动神经DCMAPD诊断CIDP的曲线下面积分别为0.940、0.989、0.915和0.919。结论应用DCMAPD来辅助诊断CIDP是可行且有意义的,同时也能为CIDP的早期诊断提供更多的支持证据。

Objective To investigate the value of distal compound muscle action potential duration(DCMAPD)for the diagnosis of chronic inflammatory demyelinating polyneuropathy(CIDP).Methods A total of 28 patients with CIDP admitted to Hunan Provincial Brain Hospital from August 2017 to August 2022 were enrolled as the CIDP group,and 30 healthy volunteers were enrolled as the control group.DCMAPD of median nerve,ulnar nerve,tibial nerve and common peroneal nerve in the two groups were detected,and the differences of DCMAPD between the two groups were analyzed and compared.The receiver operating characteristic curve(ROC)was used to analyze the value of DCMAPD in the diagnosis of CIDP,and the optimal critical value of DCMAPD was further analyzed.Results Compared with the control group,the DCMAPD of the median nerves,ulnar nerves,tibial nerves and common peroneal nerves in the CIPD group were significantly prolonged(all P<0.001).ROC curve analysis showed that the areas under the curve of DCMAPD of median nerve,ulnar nerve,tibial nerve and common peroneal nerve in diagnosing CIDP were 0.940,0.989,0.915 and 0.919 respectively.Conclusion The application of DCMAPD in the diagnosis of CIDP is feasible and meaningful,and it can also provide more supporting evidence for the early diagnosis of CIDP.