Kimura I, Ayyar D R, Sato G, Kogure K
Tohoku J Exp Med. 1983 Nov;141(3):351-8. doi: 10.1620/tjem.141.351.
Orbicularis oculi fatiguability following maximal voluntary contraction and its recovery after administration of Tensilon (edrophonium chloride) were studied in 13 patients with myasthenia gravis (MG) and 8 normal controls. The number of EMG pulses per sec (C) was calculated using an experimentally manufactured EMG pulse counting system and the mean amplitude of the motor unit potentials per sec (A) was measured using the action potential analysis module (Medelec APA-6 MK-1) during maximal voluntary contraction of the orbicularis oculi muscle. Fatiguability was estimated as percentage change of C, the pre-exercise value being taken as 100%. It was 74.4 +/- 18.2% (mean +/- S.D.) in patients and was significantly different from 110.8 +/- 8.4% found in the controls (p less than 0.01). Recovery following intravenous injection of Tensilon was estimated as percentage change in C and A, the values before Tensilon injection being taken as 100%. The change in EMG pulse per sec (C) was 360.0 +/- 90.0% in MG and 113.0 + 21.2% in controls (p less than 0.005). The mean amplitude of the motor unit potential per sec (A) increased by 180.0 +/- 95.0% in MG and 120.0 +/- 42.0% in controls (p less than 0.01). This technique is thought to be valuable to confirm the diagnosis of MG when routine electrophysiological tests fail to demonstrate abnormalities in neuromuscular transmission.
对13例重症肌无力（MG）患者和8名正常对照者进行了研究，观察眼轮匝肌最大自主收缩后的疲劳性以及注射腾喜龙（氯化依酚氯铵）后的恢复情况。使用实验制造的肌电图脉冲计数系统计算每秒肌电图脉冲数（C），并在眼轮匝肌最大自主收缩期间，使用动作电位分析模块（Medelec APA - 6 MK - 1）测量每秒运动单位电位的平均幅度（A）。疲劳性以C的百分比变化来估计，运动前的值设为100%。患者的疲劳性为74.4±18.2%（平均值±标准差），与对照组的110.8±8.4%有显著差异（p<0.01）。静脉注射腾喜龙后的恢复情况以C和A的百分比变化来估计，腾喜龙注射前的值设为100%。MG患者每秒肌电图脉冲（C）的变化为360.0±90.0%，对照组为113.0 + 21.2%（p<0.005）。MG患者每秒运动单位电位的平均幅度（A）增加了180.0±95.0%，对照组增加了120.0±42.0%（p<0.01）。当常规电生理测试未能显示神经肌肉传递异常时，这种技术被认为对确诊MG有价值。
