文章摘要
王春雷,侯友文,石秋环,李国强,刘照寒,朵慧敏.特发性面神经麻痹患者的运动单位数目评估与临床[J].,2019,19(13):2576-2578
特发性面神经麻痹患者的运动单位数目评估与临床
Estimation of the Number of Motor Units in Patients with Idiopathic Facial Paralysis
投稿时间:2018-11-26  修订日期:2018-12-21
DOI:10.13241/j.cnki.pmb.2019.13.040
中文关键词: 特发性面神经麻痹  面神经传导速度  运动单位数目估计
英文关键词: Idiopathic facial paralysis  Facial nerve conduction velocity  Motor unit number estimate
基金项目:哈尔滨市科技创新人才研究专项基金项目(2017RAQXJ220);黑龙江省卫生计生委科研项目(2017-209)
作者单位E-mail
王春雷 哈尔滨市第二医院 神经内科 黑龙江 哈尔滨 150036 oems@qq.com 
侯友文 哈尔滨市第二医院 神经内科 黑龙江 哈尔滨 150036  
石秋环 哈尔滨市第二医院 神经内科 黑龙江 哈尔滨 150036  
李国强 哈尔滨市第二医院 神经内科 黑龙江 哈尔滨 150036  
刘照寒 哈尔滨市第二医院 神经内科 黑龙江 哈尔滨 150036  
朵慧敏 哈尔滨医科大学附属第二医院 物理诊断科 黑龙江 哈尔滨 150001  
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中文摘要:
      摘要 目的:通过对特发性面神经麻痹患者的运动单位数目估计,并与常规面神经传导速度相结合,评估病情的严重程度,以期指导临床治疗和评价预后。方法:纳入我院诊断的特发性面神经麻痹患者32例,分别于发病第3天、第7天、第14天、1个月、3个月给予电生理检查,包括面神经传导速度、眼轮匝肌和口轮匝肌的运动单位数目估计,并与健侧做对比。根据House-Brackmann面神经功能分级再将入组患者分为轻(Ⅱ级)、中(Ⅲ级)、重度(Ⅳ~Ⅵ级)三组。同时纳入10名健康成年人作对照组,检测方法相同。结果:发病第3天、第7天32例患者全部出现患侧运动波幅下降,与健侧对比差异有统计学意义(P<0.05)。于发病第14天开始,患者运动波幅开始逐渐恢复,至3个月时,绝大部分患者运动波幅与健侧对比差异无统计学意义(P>0.05)。而运动单位数目的减少在整个病程中与健侧相比较差异均具有统计学意义(P<0.05),第14天、1个月、3个月运动波幅开始恢复时,运动单位数目并未随之恢复,且与运动波幅不呈线性关系,与临床症状也不成正比关系。面神经运动单位数目下降的程度与患者面神经运动波幅的恢复呈正相关。结论:运动单位数目估计检查应用于特发性面神经麻痹患者,可以反映病情的严重程度,并能在一定程度上评估预后。
英文摘要:
      ABSTRACT Objective: To assess the severity of disease by estimating the number of motor units in patients with idiopathic facial paralysis and combining it with the conventional facial nerve conduction velocity, and guide the clinical treatment and prognostic evaluation. Methods: Thirty -two patients with idiopathic facial paralysis diagnosed in our hospital were given electrophysiological examinations on the 3rd, 7th, 14th day, 1st and 3rd month of onset, including the estimation of facial nerve conduction velocity, the number of motor units of orbicularis oculi and orbicularis oris muscle, and compared with the healthy side. According to House - BrackMann's facial nerve function classification, patients in the group were divided into three groups: mild (Ⅱ), moderate (Ⅲ) and severe (Ⅳ-Ⅵ). At the same time, 10 healthy adults were included as the control group, and the test methods were the same. Results: On the 3rd and 7th day of onset, all the 32 patients showed a decrease in the amplitude of movement on the affected side, which was statistically significant compared with the healthy side (P<0.05). From the 14th day of onset, the patient's movement amplitude began to recover gradually, and by the 3rd month, there was no statistical difference between the majority of patients' movement amplitude and the healthy side (P>0.05). However, the decrease in the number of exercise units was statistically significant compared with the healthy side during the whole course of the disease (P<0.05). when the amplitude of exercise began to recover at the 14th day, 1st month and 3rd month, the number of exercise units did not recover with it, and there was no linear relationship with the amplitude of exercise, nor was it proportional to the clinical symptoms. The degree of decrease in the number of facial nerve movement units is positively related to the recovery of facial nerve movement amplitude in patients. Conclusion: The number of motor units can contribute to the reflect the severity of the disease and evaluate the prognosis of patients with idiopathic facial paralysis.
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