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目的研究重症肌无力(myasthenia gravis,MG)合并肌电图肌源性损害患者的临床和电生理特点。方法收集1998—2006年中国医学科学院北京协和医院神经科肌电图室收治的 MG合并肌源性损害患者共53例,对其临床和电生理特点进行回顾性分析。结果在本组患者中,早发型患者占69.81%(37/53),早发型中女性患者明显多于男性(分别为26例和11例,X~2=5.281,P<0.05)。延髓部肌肉受累者多见,占50.94%(27/53)。仅1例患者具有肌肉萎缩的临床表现。合并其他免疫相关疾病患者占15.09%(8/53)。2例患者(3.77%)重复频率电刺激正常,但肌电图示肌源性损害。15例患者进行肌酶谱检查,其中1例轻度异常。结论对于 MG 合并肌源性损害的患者,要结合临床特征、电生理检查等进行综合分析来区别“真性”和“假性”的肌源性损害。行甲状腺功能、自身抗体等检查有助于发现潜在的自身免疫系统疾病。
Objective To study the clinical and electrophysiological characteristics of myasthenia gravis (MG) patients with myogenic damage of electromyography. Methods A total of 53 patients with myogenic lesions of MG were collected from the electromyography room of the Peking Union Medical College Hospital from the year of 1998 to 2006 in our hospital. The clinical and electrophysiological characteristics were retrospectively analyzed. Results In this group of patients, 69.81% (37/53) were early-onset patients and more early-onset women than men (26 and 11, respectively, X ~ 2 = 5.281, P <0.05). Medullary muscle involvement more common, accounting for 50.94% (27/53). Only 1 patient had clinical manifestations of muscle wasting. Patients with other immune-related diseases accounted for 15.09% (8/53). Electrical stimulation was normal in 2 patients (3.77%) at repetition frequency, but EMG showed myogenic damage. Fifteen patients underwent muscle zymography, with a mild abnormality. Conclusion In patients with myogenic lesions of MG, comprehensive analysis of clinical features, electrophysiological examination, etc. should be used to distinguish the myogenic lesions of “true” and “pseudo”. Hypothyroidism, autoantibodies and other tests can help find potential autoimmune diseases.