H 反射在诊断多发性神经病中的应用。
Utility of the H-reflex in diagnosing polyneuropathy.
机构信息
Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark.
出版信息
Muscle Nerve. 2019 Oct;60(4):424-428. doi: 10.1002/mus.26639. Epub 2019 Jul 30.
INTRODUCTION
An absent Hoffman (H)-reflex, the electrophysiological equivalent of the Achilles reflex, is assumed to be one of the first detectable signs of polyneuropathy (PNP). In this study we compare the H- and Achilles reflexes in patients with suspected PNP to evaluate the diagnostic utility of the H-reflex.
METHODS
Data from clinical examination and nerve conduction studies (NCS) were analyzed in patients with suspected PNP.
RESULTS
The PNP diagnosis was confirmed by follow-up in 209 patients. The sensitivities of the H- and Achilles reflexes were similar (70.3% vs 71.8%), whereas the H-reflex had higher specificity (85.2% vs 70.5%) (P < .001). Adding H-reflex to the NCS protocol increased the diagnostic sensitivity from 80.9% to 87.6%.
DISCUSSION
The H-reflex is a sensitive method that could provide added value to standard NCS in PNP diagnosis. The simplicity and high specificity make it superior to its clinical equivalent, the Achilles reflex.
简介
Hoffman（H）反射缺失，相当于跟腱反射的电生理表现，被认为是多发性神经病（PNP）最早可检测到的迹象之一。在这项研究中，我们比较了疑似 PNP 患者的 H 反射和跟腱反射，以评估 H 反射的诊断效用。
方法
对疑似 PNP 患者的临床检查和神经传导研究（NCS）数据进行分析。
结果
209 例患者通过随访确诊为 PNP。H 反射和跟腱反射的敏感性相似（70.3% vs 71.8%），而 H 反射的特异性更高（85.2% vs 70.5%）（P <.001）。将 H 反射添加到 NCS 方案中，可将诊断敏感性从 80.9%提高到 87.6%。
讨论
H 反射是一种敏感的方法，在 PNP 诊断中可以为标准 NCS 提供附加价值。其简单性和高特异性使其优于临床等效的跟腱反射。
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