| 徐莹鑫，袁景林，赵留庄，杨海华.肌电图对中重度特发性面神经麻痹的预后评估[J].神经损伤功能重建,2025,(知网首发): |
| 肌电图对中重度特发性面神经麻痹的预后评估 |
| Prognostic Evaluation of Moderate to Severe Idiopathic Facial Nerve Palsy by Electromyography |
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| DOI： |
| 中文关键词: 特发性面神经麻痹 面神经电图 瞬目反射 预后 HB分级 |
| 英文关键词: idiopathic facial paralysis electroneurography blink reflex prognosis House-Brackmann grading |
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| 中文摘要: |
| 目的：探讨联合瞬目反射（blink reflex，BR）和面神经电图（electroneurography，ENoG）对特发性面神经
麻痹（idiopathic facial nerve palsy，IFP）临床预后的预测价值。方法：前瞻性纳入2022年5月至2023年5月我
院发病7 d内的急性中重度IFP（House-Brackmann分级 ≥ 3）的患者。所有患者在发病7～10 d进行BR和
ENoG检查，在发病3个月复诊时通过House-Brackmann分级法评估患者面神经功能的预后情况，预后不良
定义为HB分级 ≥ 3。采用二元Logistic回归分析联合BR和ENoG与患者3个月预后不良的相关性。结
果：总共纳入127例急性中重度IFP患者，其中11例患者（8.7%）在3个月随访时存在预后不良。单因素分析
显示，与预后良好组相比，预后不良组的年龄、初始HB分级均高于预后良好组（均P＜0.05）。与患侧BR部
分出波合并ENoG轻度下降相比，BR全未出波合并ENoG明显下降组3个月预后不良的风险显著增加（OR
10.87，95%CI 1.20～98.47，P=0.034)，ROC分析显示，联合BR和ENoG能预测IFP不良预后（AUC=0.765，P=
0.011）。结论：IFP患者同时存在BR全未出波和ENoG明显下降，其3个月不良预后的风险显著增高。提示
联合应用BR和ENoG检测可准确地评估IFP患者临床预后，为早期干预和个体化治疗提供重要依据。 |
| 英文摘要: |
| To investigate the predictive value of combined blink reflex (BR) and electroneurography
(ENoG) for the clinical prognosis of idiopathic facial nerve palsy (IFP). Methods: Patients with acute moderate
to severe IFP (House-Brackmann [HB] grade ≥ 3) who presented within 7 days of onset at our hospital from
May 2022 to May 2023 were prospectively included. All patients underwent BR and ENoG examinations 7～10
days after onset. The prognosis of facial nerve function was assessed using the HB grading system at the 3-month
follow-up visit, with poor prognosis defined as an HB grade ≥ 3. Binary logistic regression analysis was used to
evaluate the correlation between the combined BR and ENoG results and poor 3-month prognosis. Results: A
total of 127 patients with acute moderate to severe IFP were included, among whom 11 patients (8.7% ) had a
poor prognosis at the 3-month follow-up. Univariate analysis showed that compared with the good prognosis
group, the poor prognosis group had a higher age and initial HB grade (both P<0.05). Compared with the group
showing partial BR wave presence combined with mild ENoG decline on the affected side, the group with
complete absence of BR waves combined with significant ENoG decline had a significantly increased risk of
poor 3-month prognosis (OR 10.87, 95% CI 1.20～98.47, P=0.034). Receiver operating characteristic (ROC)
analysis demonstrated that the combination of BR and ENoG could predict poor prognosis in IFP (AUC=0.765,
P=0.011). Conclusion: Patients with IFP who exhibit both complete absence of BR waves and significant
ENoG decline have a significantly increased risk of poor 3-month prognosis. This suggests that the combined
application of BR and ENoG testing can accurately assess the clinical prognosis of IFP patients, providing an
important basis for early intervention and individualized treatment. |
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