Shi Lei, Liu Heng-Fang, Zhang Min, Guo Ya-Pei, Song Bo, Song Chang-Dong, Song Dan-Dan, Xu Yu-Ming
Department of Neurology, The Fifth Affiliated Hospital of Zhengzhou University Zhengzhou 450000, Henan, China.
Department of Neurology, The First Affiliated Hospital of Zhengzhou University Zhengzhou 450000, Henan, China.
Int J Clin Exp Med. 2015 Oct 15;8(10):19424-9. eCollection 2015.
The purpose of this study is to obtain normative values of the masseter muscle of myasthenia gravis (MG) patients and healthy volunteers by single-fiber electromyography (SFEMG). Stimulation of SFEMG in the masseter muscle was studied in 15 healthy volunteers (men 8, women 7; mean age 40.2, range 21-77) and 30 patients affected by MG (men 16, women 14; mean age 42.8, range 12-75). The mean consecutive difference (MCD) of the individual fiber and the mean MCD per study were determined in the normal group. We recommend the upper normal limit for the individual fibers of jitter and the mean MCD per study in the healthy Chinese adults of 33 µs and 22 µs respectively. Furthermore, in the MG group, the percentage of jitter > upper normal limit jitter and the impulse blocking percentage were detected, which were all significantly different compared to the normal control group (P < 0.01). The overall sensitivity was 90%, with the abnormality in 6 of the 9 ocular MG patients and 100% abnormality in the generalized MG patients. The masseter muscle SFEMG has a high degree of sensitivity. The masseter should be considered for SFEMG in the diagnosis of MG, and added routinely to the tested muscles.
本研究的目的是通过单纤维肌电图（SFEMG）获取重症肌无力（MG）患者和健康志愿者咬肌的正常参考值。对15名健康志愿者（男性8名，女性7名；平均年龄40.2岁，范围21 - 77岁）和30名MG患者（男性16名，女性14名；平均年龄42.8岁，范围12 - 75岁）的咬肌进行SFEMG刺激研究。在正常组中确定了单根纤维的平均连续差值（MCD）以及每项研究的平均MCD。我们建议中国健康成年人单根纤维的颤抖和每项研究的平均MCD的正常上限分别为33微秒和22微秒。此外，在MG组中，检测了颤抖>正常上限颤抖的百分比和冲动阻滞百分比，与正常对照组相比均有显著差异（P < 0.01）。总体敏感性为90%，9例眼肌型MG患者中有6例异常，全身型MG患者异常率为100%。咬肌SFEMG具有高度敏感性。在MG诊断中应考虑对咬肌进行SFEMG检查，并常规添加到检测肌肉中。
