目的: 分析急性炎性脱髓鞘性多发性神经病( AIDP) 病人早期临床特征和电生理学检查特点，并探
讨与该病病情严重程度相关的因素。方法: 回顾性分析2010－01 ～ 2016－03 内蒙古医科大学附属医院收治的
AIDP 病人82 例，病人病情等级根据Hughes 评分划分为轻型和重型AIDP．结果: 重型AIDP 临床特点: 年龄＞50
岁，伴有饮水呛咳及共济障碍，与轻型比较有显著性差异( P＜0．05) 。重型AIDP 电生理特点: 上肢SNAP 波幅降
低，上下肢SCV 减慢，下肢腓肠神经，腓浅神经SCV，与轻型病人比较有显著性差异( P＜0．05) ，上下肢MCV 均减
慢，下肢腓总神经，胫神经MCV 明显减慢，与轻型比较有显著性差异( P＜0．05) ; CMAP 波幅降低，与轻型比较，有
显著性差异( P＜0．05) 。结论: Hughes 评分高，年龄＞50 岁，伴有饮水呛咳及共济障碍的AIDP 病人，病情重，恢复
慢，预后差; AIDP 病人以周围神经节段性脱髓鞘病变为主，同时存在轴索损害，运动、感觉神经均有受累，运动障
碍重于感觉异常，下肢重于上肢。神经电生理检测中，F 波异常是早期诊断的敏感指标，MCV 减慢、CMAP 波幅
降低程度是评估病情严重程度及预后的可靠指标。

Objective: To analyze early clinical characteristics and electrophysiology in patients
with the acute inflammatory demyelinating polyneuropathies( AIDP) ． and discuss． the main predictors
relating to the progression of disease．Methods: We adopt retrospective analysis method to assess 82 cases
of AIDP patients，admitted in Inner Mongolia medical university affiliated hospital between January
2010 and March 2016，and Hughes scale was used to evaluate the clinical status of patients with AIDP．
And the Level of patients were divided into light and heavy AIDP．Results: the clinical features with
heavy AIDP: ＞ 50 years old，Choking cough of drinking water，ataxia，and there was significant
difference( P＜0．05) compared with light AIDP．The electrophysiological data with Heavy AIDP: upper
limb sensory nerve action potential( SNAP) amplitude reduced， slow onset of sensory conductive velocity
( SCV) ，The SCV of Suralis and Sup－peroneal was compared with patients with light AIDP，and there
was significant difference ( P ＜ 0．05) ，Onset of the MCV was slowing down，The motor conduction
velocity( MCV) of Peroneus and Tibialis had slowed significantly，and there was significant difference
( P＜0．05) compared with light AIDP，CMAP amplitude was significantly reduced，and there was significant
difference( P＜0．05) compared with light AIDP．Conclusion: The severe AIDP patients more frequently
had a higher Hughes score，＞ 50years old，Choking cough of drinking water，ataxia，the
condition was worse， restore was slower，prognosis was poor．The electrophysiological characteristics with
AIDP was priority to nerve segments around sexual demyelinating lesions，and had axonal damage at the
same time，Motor nerve and sensory nerves were affected， the injury of distal motor nerve is more severe
than the sensory nerve．The damage of nerve in the lower limbs is more severe than the upper limbs．The
neural electrophysiological data of AIDP showed: abnormal F wave was sensitive marker to early diagnosis．
slower MCV and the decrease degree of CMAP amplitude were the most reliable indicators to assess
condition and were correlated positively with the disease severity and prognosis．

R 745．43

 收稿日期: 2016－11－18; 修回日期: 2016－12－18
基金项目: 内蒙古自治区卫计委研究项目( 201301045)
作者简介: 王银霞( 1975－) ，女，内蒙古医科大学附属医院神经内科副主任医师。
通讯作者: 吴荷花，主任技师，E－mail: hehua@ live．ca 内蒙古医科大学附属医院肌电图室， 010050