fa بررسی وضعیت سرولوژیک و الکتروفیزیولوژیک بیماران مبتلا به میاستنی گراویس مغز و اعصاب Neurology پژوهشي Research <font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0%" dir="rtl"><b><span lang="FA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt mso-bidi-language: FA">زمینه و هدف</span></b><span lang="FA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt mso-bidi-language: FA">: میاستنی گراویس نوعی اختلال خود ایمنی است که به طور اساسی در اثر آنتی بادی‌های ضد رسپتور استیل کولین در محل اتصال عصب به عضله ایجاد شده و کاهش رسپتورهای مذکور سبب اختلال در انتقال نوروترانسمیتر و خستگی و ضعف عضلانی می‌شود. این آنتی بادی در تمام بیماران تشخیص داده نمی‌شود و بررسی‌های الکتروفیزیولوژیک برای تشخیص برخی از این بیماران ضروری است. در این مطالعه نتایج آزمایش‌های <font size="2"><font face="B Mitra"><span style="mso-spacerun: yes"> </span>سرولوژیک و الکتروفیزیولوژیک در بیماران مبتلا به میاستنی گراویس بررسی شده است. <o:p /></font></font></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0%" dir="rtl"><b><span lang="FA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt mso-bidi-language: FA">روش کار:</span></b><span lang="FA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt mso-bidi-language: FA"> یک صد و دوازده بیمار وارد یک مطالعه مقطعی شدند. سطح سرمی آنتی بادی‌های ضد رسپتور استیل کولین اندازه گیری و آزمون <span style="mso-spacerun: yes"><font face="B Mitra" size="2"> </font></span></span><span style="color: rgb(35, 31, 32) font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt" dir="ltr">Repetitive nerve stimulation (RNS)</span><span dir="rtl"></span><span style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt mso-bidi-language: FA"><span dir="rtl"></span> <span lang="FA"><font face="B Mitra" size="2">انجام شد. شیوع موارد مثبت آنتی بادی و موارد غیر طبیعی </font></span></span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt mso-bidi-language: FA" dir="ltr">RNS</span><span dir="rtl"></span><span style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt mso-bidi-language: FA"><span dir="rtl"></span> <span lang="FA"><font face="B Mitra" size="2">و ارتباط میان این دو تعیین شد. </font></span></span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt mso-bidi-language: FA" dir="ltr"><o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0%" dir="rtl"><b><span lang="FA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt mso-bidi-language: FA">یافته‌ها</span></b><span lang="FA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt mso-bidi-language: FA">: <span style="color: black"><font face="B Mitra" size="2">30 بیمار مذکر (8/26%) و 82 بیمار مونث (2/73%) و میانگین سنی بیماران 4/15</font></span></span><span lang="FA" style="color: black font-family: "Arial","sans-serif" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-bidi-font-family: Arial mso-bidi-theme-font: minor-bidi mso-ansi-font-size: 9.0pt mso-bidi-language: FA">±</span><span lang="FA" style="color: black font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt mso-bidi-language: FA">6/37 سال بود. </span><span lang="FA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt mso-bidi-language: FA">در 71 بیمار (4/63%) آنتی بادی علیه رسپتور استیل کولین مثبت و در 41 بیمار (6/36%) منفی بود. آزمون </span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt mso-bidi-language: FA" dir="ltr">RNS</span><span dir="rtl"></span><span style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt mso-bidi-language: FA"><span dir="rtl"></span> <span lang="FA"><font face="B Mitra" size="2">در 101 بیمار انجام شده بود که در 74 نفر (73.3%) </font></span></span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt mso-bidi-language: FA" dir="ltr">RNS</span><span dir="rtl"></span><span style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt mso-bidi-language: FA"><span dir="rtl"></span> <span lang="FA"><font face="B Mitra" size="2">غیر طبیعی و 27 نفر (26.7%) </font></span></span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt mso-bidi-language: FA" dir="ltr">RNS</span><span dir="rtl"></span><span style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt mso-bidi-language: FA"><span dir="rtl"></span> <span lang="FA"><font face="B Mitra" size="2">طبیعی گزارش شد. در بیماران سروپوزیتیو در 4/84% و در بیماران سرونگاتیو در 7/53% موارد </font></span></span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt mso-bidi-language: FA" dir="ltr">RNS</span><span dir="rtl"></span><span style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt mso-bidi-language: FA"><span dir="rtl"></span> <span lang="FA"><font face="B Mitra" size="2">غیر طبیعی بود (001/0=</font></span></span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt mso-bidi-language: FA" dir="ltr">p</span><span dir="rtl"></span><span lang="FA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt mso-bidi-language: FA"><span dir="rtl"></span>).</span><span style="font-family: "Times New Roman","serif" font-size: 9pt mso-bidi-font-family: "B Mitra" mso-bidi-font-size: 10.0pt mso-bidi-language: FA" dir="ltr"><o:p /></span></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify line-height: normal unicode-bidi: embed direction: rtl text-justify: kashida text-kashida: 0%" dir="rtl"><b><span lang="FA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt mso-bidi-language: FA">نتیجه گیری</span></b><span lang="FA" style="font-family: "B Mitra" font-size: 10pt mso-ascii-font-family: "Times New Roman" mso-hansi-font-family: "Times New Roman" mso-ansi-font-size: 9.0pt mso-bidi-language: FA">: میان یافته‌های سرولوژیک و الکتروفیزیولوژیک در بیماران مبتلا به میاستنی گراویس رابطه معنی داری وجود دارد و آزمون‌های الکتروفیزیولوژیک در کنار آزمون‌های سرولوژیک می ‌تواند سبب افزایش دقت تشخیص میاستنی گراویس گردد. <o:p /></span></p><font face="Times New Roman" size="3"> </font> <font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify text-autospace: text-justify: kashida text-kashida: 0% mso-layout-grid-align: none"><font size="3"><b><span style="font-family: "Times New Roman","serif"">Background</span></b><span style="font-family: "Times New Roman","serif"">: Myasthenia gravis is an autoimmune disorder mainly caused by antibodies to the muscle acetylcholine receptors (AChR-Ab) at the neuromuscular junction. Loss of these receptors leads to a defect in neuromuscular transmission with muscle weakness and fatigue. This antibody is not detected in all the patients and electrophysiologic study is necessary in some patients </span><span style="font-family: "Times New Roman","serif" mso-bidi-language: FA">as a diagnostic tool.</span><span style="font-family: "Times New Roman","serif""> The serologic and electrophysiologic tests in Myasthenia gravis are evaluated in this study.<span lang="AR-SA" dir="rtl"><o:p /></span></span></font></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify text-autospace: text-justify: kashida text-kashida: 0% mso-layout-grid-align: none"><font size="3"><b><span style="font-family: "Times New Roman","serif"">Methods</span></b><span style="font-family: "Times New Roman","serif"">: One hundred twelve patients entered in a cross-sectional study. Serum AChR-Ab was measured and <font face="Times New Roman"><span style="color: rgb(35, 31, 32)">Repetitive nerve stimulation (RNS) was done. The frequency of positive AChR-Ab and abnormal RNS and the relationship between them were determined. </span><span style="mso-spacerun: yes"> </span><o:p /></font></span></font></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify text-autospace: text-justify: kashida text-kashida: 0% mso-layout-grid-align: none"><font size="3"><b><span style="font-family: "Times New Roman","serif"">Results</span></b><span style="font-family: "Times New Roman","serif"">: Thirty (26.8%) patients were males and 82 (73.2%) were females. Mean of age was 37.6±15.4 years. AChR-Ab was positive in 71 (63.4%) and negative in 41 (36.6%). RNS was done in 101 patients and was abnormal in 74 (73.3%) and normal in 27 (26.7%) patients. Ratio of abnormal RNS was 84.4% and 53.7% in seropositive and seronegative patients, respectively (p=0.001).<font face="Times New Roman"><span style="mso-spacerun: yes"> </span><span lang="AR-SA" dir="rtl"><o:p /></span></font></span></font></p><font face="Times New Roman" size="3"> </font><p class="MsoNormal" style="margin: 0in 0in 0pt text-align: justify text-autospace: text-justify: kashida text-kashida: 0% mso-layout-grid-align: none"><font size="3"><b><span style="font-family: "Times New Roman","serif"">Conclusion</span></b><span style="font-family: "Times New Roman","serif"">: There is significant relationship between serologic and </span><span style="font-family: "Times New Roman","serif" mso-bidi-language: FA">electrophysiological</span><span style="font-family: "Times New Roman","serif""> findings in Myasthenia gravis</span><span style="font-family: "Times New Roman","serif" mso-bidi-language: FA">. Combining electrophysiological and serological tests could increase the accuracy of </span><span style="font-family: "Times New Roman","serif"">Myasthenia gravis diagnosis.</span><span style="font-family: "Times New Roman","serif" mso-bidi-language: FA"><o:p /></span></font></p><font face="Times New Roman" size="3"> </font> میاستنی گراویس، AChR-Ab ، RNS. Myasthenia gravis, AChR-Ab, RNS. 8 14 http://rjms.iums.ac.ir/browse.php?a_code=A-10-1-1383&slc_lang=fa&sid=1 Zahra Vahabi زهرا وهابی 3900319475328460022781 3900319475328460022781 No Tehran University of Medical Sciences دانشگاه علوم پزشکی تهران Shahriar Nafisi شهریار نفیسی 3900319475328460022782 3900319475328460022782 Yes Tehran University of Medical Sciences دانشگاه علوم پزشکی تهران Fatemeh Safarian فاطمه صفاریان 3900319475328460022783 3900319475328460022783 No Zahra Safarian زهرا صفاریان 3900319475328460022784 3900319475328460022784 No Ali Akbar Amirzargar علی اکبر امیرزرگر 3900319475328460022785 3900319475328460022785 No Tehran University of Medical Sciences دانشگاه علوم پزشکی تهران Akbar Soltanzadeh اکبر سلطانزاده 3900319475328460022786 3900319475328460022786 No Tehran University of Medical Sciences دانشگاه علوم پزشکی تهران Hajir Sikarodi هژیر سیکارودی 3900319475328460022787 3900319475328460022787 No Tehran University of Medical Sciences دانشگاه علوم پزشکی تهران