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波鸿超声评分与临床及电生理参数在区分急性起病慢性炎症性脱髓鞘性多发性神经病和急性炎症性脱髓鞘性多发性神经病中的比较

Bochum ultrasound score versus clinical and electrophysiological parameters in distinguishing acute-onset chronic from acute inflammatory demyelinating polyneuropathy.

作者信息

Kerasnoudis Antonios, Pitarokoili Kallia, Behrendt Volker, Gold Ralf, Yoon Min-Suk

机构信息

Department of Neurology, St. Josef Hospital, Ruhr-University of Bochum, Gudrunstr. 56, 44791, Bochum, Germany.

出版信息

Muscle Nerve. 2015 Jun;51(6):846-52. doi: 10.1002/mus.24484. Epub 2015 Apr 24.

Abstract

INTRODUCTION

The aim of this study was to evaluate whether a nerve ultrasound score (Bochum ultrasound score, BUS), clinical, and electrophysiological parameters could distinguish subacute chronic (CIDP) from acute inflammatory demyelinating polyneuropathy (AIDP).

METHODS

Phase 1: The charts of 35 patients with polyradiculoneuropathy were evaluated retrospectively regarding BUS, clinical, and electrophysiological parameters (A-waves, sural nerve sparing pattern, sensory ratio>1). Phase 2: All parameters were evaluated prospectively in 10 patients with subacute polyradiculoneuropathy.

RESULTS

Phase 1: A sum score of ≥2 points in BUS and the presence of sensory symptoms were significantly more frequent in the subacute CIDP group than in the AIDP group (P<0.001).The electrophysiological parameters showed no significant changes between the 2 groups. Phase 2: BUS (83.3%; 100%;), sensory symptoms (100%; 75%), absence of autonomic nervous system dysfunction (83.3%; 75%), or bulbar palsy (83.3%; 50%) showed the best sensitivity and specificity in distinguishing subacute CIDP from AIDP.

CONCLUSIONS

BUS is a useful diagnostic tool for distinguishing subacute CIDP from AIDP.

摘要

引言

本研究的目的是评估神经超声评分(波鸿超声评分,BUS)、临床和电生理参数能否区分亚急性慢性炎症性脱髓鞘性多发性神经病(CIDP)与急性炎症性脱髓鞘性多发性神经病(AIDP)。

方法

第一阶段:回顾性评估35例多神经根神经病患者的BUS、临床和电生理参数(A波、腓肠神经保留模式、感觉比率>1)。第二阶段:对10例亚急性多神经根神经病患者前瞻性评估所有参数。

结果

第一阶段:亚急性CIDP组BUS总分≥2分及存在感觉症状的情况显著多于AIDP组(P<0.001)。两组间电生理参数无显著变化。第二阶段:BUS(83.3%;100%)、感觉症状(1-00%;75%)、无自主神经系统功能障碍(83.3%;75%)或延髓麻痹(83.3%;50%)在区分亚急性CIDP与AIDP方面显示出最佳的敏感性和特异性。

结论

BUS是区分亚急性CIDP与AIDP的有用诊断工具。

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