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越南重症肌无力患者神经功能的临床及电生理特征研究

Study on the clinical and electrophysiological characteristics of nerve function in myasthenia gravis patients in Vietnam.

作者信息

Anh Pham Tho Kieu, Van Pham Phuong, Dinh Le Tung, Thanh Nguyen Binh, Kien Nguyen Trung, Thanh Tran Tam Thai, Hai Nguyen Sam Phan, Van Le Minh

机构信息

Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam.

Can Tho General Hospital, Can Tho, Vietnam.

出版信息

SAGE Open Med. 2024 Mar 25;12:20503121241229591. doi: 10.1177/20503121241229591. eCollection 2024.

Abstract

BACKGROUND

In Vietnam, there is limited research on the role of nerve conduction in myasthenia gravis and its association with clinical features.

OBJECTIVE

This study aims to describe the electrophysiological features in patients with myasthenia gravis.

METHODS

This descriptive study was conducted from September 2019 to December 2021. The study included 33 myasthenia gravis patients who sought medical consultation or received inpatient treatment during this period. The Myasthenia Gravis Foundation of America classifies myasthenia gravis into five groups: I, IIa, IIb, IIIa, IIIb, IVa, IVb, and V. Notably, Group I involves pure ocular weakness, whereas Group a primarily impacts limb and axial muscles, and Group b mainly affects bulbar and respiratory muscles.

RESULTS

The study revealed that motor and sensory nerve conduction in the upper and lower limbs were within normal limits for the patient group under evaluation. Repetitive nerve stimulation testing at a frequency of 3 Hz showed positive results in 66.7% of myasthenia gravis patients. Myasthenia gravis patients displayed distinct clinical symptoms, with ptosis being the most common (87.9%). Myasthenia Gravis Foundation of America classification indicated the highest proportion in subgroup IIa (24.2%), with myasthenia gravis predominating in limb and axial muscles (Group a) observed in 51.5% of cases. Needle electromyography showed no abnormalities in myasthenia gravis patients. There was an association between acetylcholine receptor antibody titers and the results of the 3 Hz repetitive nerve stimulation test in myasthenia gravis patients, with a significance of  = 0.002.

CONCLUSION

Nerve conduction studies should be performed in patients with suspected neuromuscular disorders to aid in differential diagnosis and definitive diagnosis of myasthenia gravis.

摘要

背景

在越南,关于神经传导在重症肌无力中的作用及其与临床特征的关联研究有限。

目的

本研究旨在描述重症肌无力患者的电生理特征。

方法

本描述性研究于2019年9月至2021年12月进行。该研究纳入了在此期间寻求医疗咨询或接受住院治疗的33例重症肌无力患者。美国重症肌无力基金会将重症肌无力分为五组:I、IIa、IIb、IIIa、IIIb、IVa、IVb和V。值得注意的是,I组涉及单纯眼肌无力,而a组主要影响肢体和躯干肌肉,b组主要影响延髓和呼吸肌。

结果

研究显示,所评估患者组的上下肢运动和感觉神经传导均在正常范围内。以3Hz频率进行的重复神经刺激测试在66.7%的重症肌无力患者中显示出阳性结果。重症肌无力患者表现出不同的临床症状,上睑下垂最为常见(87.9%)。美国重症肌无力基金会分类显示IIa亚组比例最高(24.2%),51.5%的病例观察到以肢体和躯干肌肉为主的重症肌无力(a组)。针极肌电图显示重症肌无力患者无异常。重症肌无力患者的乙酰胆碱受体抗体滴度与3Hz重复神经刺激测试结果之间存在关联,显著性为=0.002。

结论

对于疑似神经肌肉疾病的患者,应进行神经传导研究,以协助重症肌无力的鉴别诊断和明确诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f83/10964451/ca065b22da35/10.1177_20503121241229591-fig1.jpg

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