| 摘要: |
| 应用M型和二维超声评价重症肌无力危象患者膈肌收缩运动，探讨两种超声测量方式在观察膈肌运动中的应用价值。方法选取于我院神经内科住院治疗的重症肌无力危象（MC）患者38例（MC组）和与其健康成人38 例（正常对照组），应用二维超声分别测量双侧膈肌吸气末和呼气末的厚度，M型超声测量双侧膈肌取样线上最厚处及最薄处厚度，计算膈肌收缩变化率。比较两组上述参数的差异。结果与正常对照组比较，MC组二维超声、M型超声两种方法测得双侧膈肌收缩变化率均减低，差异有统计学意义（二维超声P=0.000，M型超声P=0.000）。正常对照组内两种方法测得的双侧膈肌收缩变化率比较差异无统计学意义；MC组内两种方法测得右侧膈肌收缩变化率比较差异有统计学意义（r=0.937，t=3.038，P=0.004）。MC组内二维超声对左、右侧膈肌收缩变化率测值比较差异有统计学意义（r=0.818，t=-2.226，P=0.032）。结论应用超声测量膈肌收缩变化率，可以量化评价膈肌的收缩功能，可用于MC患者膈肌功能改变的观测；M型超声较二维超声能更好地反映膈肌收缩功能的变化。 |
| 关键词: 超声检查 膈肌运动 收缩 重症肌无力 |
| DOI： |
| 投稿时间：2018-01-14修订日期：2019-01-09 |
| 基金项目: |
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| Evaluation of diaphragmatic contractile motion in patients with myasthenia gravis crisis by M and two-dimensional ultrasound |
| Li wenyan |
| (Department of Neurology,Yongchuan hospital of Chongqing Medical University) |
| Abstract: |
| ABSTRACT ObjectiveTo evaluate the M and two-dimensional ultrasound used in diaphragmatic contraction movement in patients with myasthenia gravis crisis，and to explore the application value of two kinds of ultrasonic measurement in diaphragm movement. Methods The study enrolled 38 patients with myasthenia gravis crisis （MC） in our department of Neurology，including 11 males and 27 females from January 2016 to December 2017 . At the same time，38 healthy people with similar height，weight and age were selected as the control group. The thickness of inhale and exhalation end of bilateral diaphragm was measured respectively by two-dimensional ultrasound，and then the thickness of the thickness and thinnest of bilateral diaphragm sampling line was measured by M-mode ultrasound，and the change rate of diaphragm contraction was obtained by calculating（Δtdi%）. Results The two methods of two-dimensional ultrasound and M ultrasound showed that the change rate of diaphragmatic contraction was significantly higher than that of group MC （P=0.000），and the difference was statistically significant.In the normal control group，there was no significant difference in the difference of the bilateral diaphragmatic Δtdi% between the two methods of ultrasonic measurement. In group MC，there were significant differences in the difference of the right diaphragmatic Δ tdi% between two methods （r=0.937，t=3.038，P=0.004<0.05）. Conclusion This study shows that ultrasound can measure the diaphragmatic contraction ofΔ tdi%，which can be quantified to evaluate the contractile function of the diaphragm and to be used to observe the changes of diaphragmatic function in MC patients. In MC patients，M ultrasound can better reflect the changes in the contractile function of the diaphragm than the two-dimensional ultrasound. |
| Key words: ultrasound,diaphragmatic motion,contractile, myasthenia gravis crisis |
