摘要
目的评估异常肌反应(abnormal muscle response,AMR)检测在面肌痉挛(hemifacial spasm,HFS)诊断及鉴别诊断中的价值。方法选取因眼轮匝肌痉挛就诊于作者医院的50例患者,其中41例最终经临床诊断为HFS,7例为眼睑痉挛(blepharospasm,BSP),2例为特发性眼睑-口下颌肌张力障碍(Meige综合征)。回顾性分析以上三组患者面肌的AMR检测结果,检测方法为刺激面神经下颌缘后,记录同侧眼轮匝肌的AMR检测结果。分析这三种疾病的AMR阳性率,如三组间比较差异有统计学意义(P<0.05),则进一步分析HFS患侧组AMR阳性率分别与其余两组比较差异是否有统计学意义;并根据HFS患者及非HFS患者AMR的检测结果,计算出AMR诊断HFS的灵敏度、特异度、阳性预测值、阴性预测值及约登指数。结果在41例HFS患者中患侧面肌AMR阳性率为95.12%(39例),眼睑痉挛组、Meige综合征组中AMR阳性率均为0%(0例),三组间AMR阳性率比较差异有统计学意义(P<0.05);HFS患侧组分别与其余两组比较,AMR阳性率均高于其他两组,差异均有统计学意义(均P<0.0167)。应用AMR检测来诊断HFS,灵敏度为95.12%,特异度为100%,阳性预测值为100%,阴性预测值为95.35%,约登指数为0.95%。结论 AMR检测对HFS的诊断及鉴别诊断可能具有重要参考价值。
Objective To evaluate the value of abnormal muscle response（AMR）in diagnosis and differential diagnosis of hemifacial spasm（HFS）.Methods Fifty patients with blepharospasm（BSP）were selected from our hospital.Forty-one patients were clinically diagnosed as HFS,7patients as BSP and 2patients as Meige syndrome.The AMR test results of hemifacial patients were retrospectively analyzed among the patients in three groups by stimulating marginal mandibular branch of the facial nerve and the AMR test results of the ipsilateral orbicularis oculi muscle were recorded.The AMR test positive rate and statistical differences in the three groups were analyzed.If there were significant differences,further analysis would be adopted to identify if there was statistical significance in the AMR test positive rate between the HFS group and the other two groups.The sensitivity,specificity,positive predictive value,negative predictive value and Youden index of AMR test in HFS diagnosis were calculated according to the AMR test results in patients with or without HFS.Results In 41 HFS patients,the positive rate of AMR on the ill side was 95.12%（39patients）.In BSP patients and Meige syndrome patients,the positive rate of AMR was 0%.There were statistical differences of the AMR test positive rate between the three groups（P〈0.05）.Compared with the other two groups respectively,the AMR positive rate on the ill side of the HFS patients wasstatistically significant different（P〈0.0167）.The sensitivity,specificity,positive predictive value,negative predictive value and Youden index of AMR were 95.12%,100%,100%,95.35%,0.95%.Conclusions AMR plays an important role in diagnosis and differential diagnosis of HFS.
出处
《中国神经免疫学和神经病学杂志》
CAS
2016年第2期109-112,共4页
Chinese Journal of Neuroimmunology and Neurology
关键词
面肌痉挛
异常肌反应
hemifacial spasm
abnormal muscle response
