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作者报导1例重症肌无力(MG)患者在高频反复电刺激时出现Eaton-Lambert综合征(ELS)特有的肌运动电位(M波)渐增现象。男性45岁,在30岁出现眼睑下垂、复视、长时间讲话易疲劳,进行性上肢无力,咀嚼力降低而于34岁首次住院,当时反复握力测定可以从53Kg增到56Kg,腾喜龙试验握力从36Kg增到40Kg。诱发EMG时,高频反复电刺激见M波渐增,未查出癌肿,用酶抑宁与盐酸胍后症状改善出院,当时查血清抗AChR抗体正常,X线及CT扫描均未见胸腺瘤,诱发EMG与首次住院相同,用酶抑宁治疗后好转。45岁时第三次住院,血清抗AChR抗体仍正常,血清IgG629mg/dl、IgA155 mg/dl、IgM 63 mg/dl,CH5031.9 u/ml,CPK190IU/ml,电生理学检查先用2Hz反复刺激尺神经
The authors report an increase in muscle motor potential (M-wave) characteristic of Eaton-Lambert syndrome (ELS) in one patient with myasthenia gravis (MG) under repeated high-frequency electrical stimulation. Male 45 years old, eyelid ptosis at 30 years of age, diplopia, prolonged speech fatigue, progressive upper limb weakness, decreased chewing force and was hospitalized for the first time at 34 years of age, when the determination of repeated grip strength can be increased from 53Kg to 56Kg, Grip increased from 36Kg to 40Kg. EMG induced by repeated high-frequency electrical stimulation, M wave increased, did not detect the cancer, with enzyme inhibition and guanidine hydrochloride to improve the symptoms after discharge, then check the serum anti-AChR antibody normal, X-ray and CT scan showed no thymus Tumor, EMG induced the same as the first hospitalization, Enzyme inhibition after treatment improved. The third hospitalization at age 45, serum anti-AChR antibody is still normal, serum IgG629mg / dl, IgA155mg / dl, IgM63mg / dl, CH5031.9u / ml, CPK190IU / ml, electrophysiological examination with 2Hz repeated stimulation Ulnar nerve