• 제목/요약/키워드: acetylcholine receptor antibody

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중증 근무력증 진단에 있어서 제반 검사법들의 유용도 비교 (Comparison of Usefulness of Laboratory Tests in Diagnosis of Myasthenia Gravis)

  • 박승권;도현철;김민정;이승엽;박미영;하정상;김욱년;이준
    • Journal of Yeungnam Medical Science
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    • 제15권1호
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    • pp.125-134
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    • 1998
  • 1993년 1월 1일부터 1995년 6월 30일 까지 영남대학교 의과대학 부속병원 신경과에 중증 근무력증 증상을 주소로 내원한 환자 중 21명에게 텐실론검사, 반복신경자극검사, 단일근섬유 근전도 검사 및 아세틸콜린 수용체에 대한 항체 측정 검사 모두를 시행하여 각 검사의 양성률을 구하여 비교하였다. 텐실론검사에서는 양성률이 95%였고, 반복신경자극검사상 최초 한 근육이상에서 양성률을 보인 경우가 67%였고 근육별로는 안윤근에서 67%, 척측수근굴근에서 38%, 소지외전근에서 43%로 원위근육에 비해 안윤근에서 더 높은 양성률을 보였으나 통계학적인 유의성은 없었다. 한편 단일근 섬유 근전도검사, 아세틸콜린 수용체에 대한 항체 측정 양성률은 각각 87%, 76%로 텐실론검사에서 양성률이 가장 높았고, 안형에서 시행한 반복신경자극검사에서는 양성률이 45%로 가장 낮았다. 또 각각의 검사들을 안형군과 전신형으로 나누어 양성률을 비교하였을 때 모두 안형에 비해 전신형에서 양성률이 증가된 소견을 보였으나 반복 신경자극검사에서만 유의성있게 양성률이 증가하였고(p<0.05) 나머지 검사들에서는 통계학적 유의성이 없었다. 이상의 결과로 볼 때 중증 근무력중 증상이 보이는 환자에게서 우선적으로 양성률이 가장 높은 텐실론검사를 먼저 실시한 후, 반복신경자극검사와 함께 특이성을 높일 수 있도록 아세틸콜린 수용체에 대한 항체를 측정하고, 비교적 양성률이 낮은 안형에서는 단일근섬유 근전도검사를 같이 시행하면 중증 근무력증에 대한 확진률을 높일 수 있으리라고 사료된다.

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중증근무력증(重症筋無力症)에 대(對) 임상적(臨床的) 연구(硏究) (The clinical study of Myasthenia Gravis)

  • 채병윤
    • 대한한의학회지
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    • 제17권1호
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    • pp.190-211
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    • 1996
  • Generally the Myasthenia Gravis is classified into two of hereditary factor and acquement. Aquired Myasthenia Gravis was Quite well known to be caused by the autoimmune mechanism. Not in accurateness, on the hereditary, acetylcholine receptor antibody was to be analyzed very high in their parents and brothers. Also Myasthenia Gravis is a chronic disease characterized by voluntary muscle weakness and fatigue. above all, ocular Myasthenia Gravis is characterized clinically by blepharoptosis and external ophthalmoplegia and to be showed abut 90% cases and so oriental medicine can not but deal with myasthenia gravis at blepharoptosis. Accordinglv 20 out patients with Myasthenia Gravis were clinical study and observation as to the sex, age, progress state of MG, blood type, history, main symptom, liking for warm and cool food and tepidity, state of pulse, treatment of acupuncture and administration of oriental medicine etc. The results were as follows. 1. There was investigaed on the frequency of attack for sex, age, oculus dexter, oculus sinister, oculus uterque. Among the 20 patients, the number of female were 60% with 12 cases and male were 40% with 8 cases, therefore it was the rate of 6 : 4. the patients under 10 ages and 40 ages were 20% with 4 cases, 10 ages and 50 ages were 15% with 3 cases, 20, 30, 60 ages were 10% with 2 cases. And then oculus uterque was 90% with 18 cases, oculus sinister was 10% with 2 cases and oculus dexter were none of them. 2. Stage I were 50% with 10 patients, stage $II_A$ were 30% with 6 patients and stage $II_B$ were 20% with 4 patients, on the clinical stage and too class I were 20% with 4, class II were 45% with 9, class III were 35% with 7, in the functional activity the patients with chest heavy were 15% with 3 and hyperthyroidism were 10% with 2. 3. Hospital which patients had used to before came to this hospital were 10 university hospital and 6 local clinic. 4. The duration of disease was from 3 months to 30 years, the patients suffering between 3 months and within 1 year were 25% with 5 cases, 1-2 years were 30% with 6 cases, therefore within 2 years were 55%. 4-5 years were 15%, over 7 years were appeared less than 10%. 5. In the main symptom, all of patients were appeared to be heavy in opening their eyes the patients with blephroptosis were 70% with 14 cases on the oculus uterque, oculus sinisterf and oculus dexter, there were 20% with 4 eases each other in the oculogyation incomplete. visual failing, ophthalmoxerosis, strabismus etc and indigetion, frequency of urine(feel hurt), mild stools(or diarrea), oversensitiveness etc. but in addition, all of the other were 10%. 6. In the distribution of blood type, 0 types were 45% with 9 cases, A types were 25% with 5 cases, B and AB types were 15% each other. 7. For the rates of patients of liking for warm and cool food or tepidity, patients of liking for warm food possess 45% with 9 cases, and cool food possess 35% with 7 and tepidity possess 20% with 4, and then most of patients liking for warm food were females and cool food were much more males than females. 8. Hyunsae(弦細) were 40% with 8 cases, Buhurl(浮滑) were 20% with 4 cases, Hyunsak(弦數) were 15% with 3 cases, and in addition, the others were 10%, among 7 types of pulses. 9. The patients with less than 1 week were 40% with 8 cases, and there were female most of them and over 4 weeks were 20% and 1-2weeks were 15%, in the duration acupuncture treatment. 10. 15 kinds of prescriptions were administrated with oriental medicine from 1 week to 20weeks 1_2 weeks were 25.71% with 9 cases, 3 weeks were 17.14% with 6 cases and 6 weeks were 11.42% with 4 cases and also Gamibaetaugunbitang(加味培土健脾湯) were 28.57% with 10 cases, Gamijeounyongtang(加味正容湯) were 14.28% with 5 cases, Gamibojoongyigitung (加味補中益氣湯), Gamiyinsamyangyoungtung (加味人蔘養榮湯) were 8.57% with 3 cases each other and also Gamisamgitung (加味蔘?湯), Gamisamuloajatung(加味四物五子湯) Gamigoudungum (加味鉤藤飮), etc were applied.

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