【摘要】 目的探讨A波在格林-巴利综合征(CBS)诊断中的应用价值。方法本研究回顾性分析了39例GBS患者的尺、正中、腓及胫神经在进行F波检测时的A波出现情况。结果共检测122条神经,其中有26条神经在F波检测中出现了A波,以胫神经和尺神经的A波出现率最高,分别为33.3%和30.0%,正中神经为14.3%,腓神经最低,仅为6.5%;A波出现率在上肢神经与下肢神经间的差异无统计学意义(P>0.05)。本研究患者A波类型以前位型最多见,占38.5%(10/26),多发A波次之,占30.8%(8/26),混合型A波占23.1%(6/26),最少见的是后位型A波,仅占7.7%(2/26)。39例患者巾有26例于发病1周内进行F波检测,发现有16例(61.6%)至少一条神经存在F波异常,12例(46.2%)至少一条神经出现A波,F波异常率与A波出现率间的差异无统计学意义(P>0.05),并且有7例患者虽然F波正常,却出现了A波。结论临床上当患者上肢神经出现A波时,尤其是多发A波时应引起足够重视,提示患者可能存在脱髓鞘性神经病变,A波对早期诊断GBS可能具有重要参考价值。更多还原

【Abstract】 Objective To investigate the diagnostic value of A-waves in F-wave studies of patients with Guillain-BarréSyndrome.Methods A retrospective study was performed with regard to the frequency of A-waves occurred in in F-wave studies of the ulnar,median,pernneal,and tibial nerves in 39 Guillain-BarréSyndrome pa- tients.Results A-wave occurred in 33.3% of the tibial nerves studied and 30.0% of the ulnar nerves studied, but less frequent in the peroneal and median nerves.The difference of frequency between upper extremities and lower extremities was not significant(P>0.05).Among the 4 types of A-waves,the anteposition type is most frequent (38.5%),the multiple type is secondary(30.8%).In 26 patients studied during the first week after onset,there was no significant difference between the abnormality rate of F-waves and the occurrence rate of A-waves(P>0.05).However,A-waves were recorded in 7 patients who were with normal F-waves.Conclusion The occur- rence of A-waves,especially of multiple type,in the ulnar and median nerves might be helpful for the early diagnosis of Guillain-BarréSyndrome.更多还原