电生理检测中运动神经传导变异对急性炎症性脱髓鞘性多发性神经病的评估意义  

Evaluating significance of abnormal motor nerve conduction on acute inflammatory demyelinating polyradiculoneuropathy in electrophysiological detection

作　　者：张云书[1] 高长玉[1] 王淑英[1] 潘栓珍[1] 陈桂英[1] 刘桂宇[1] 

机构地区：[1]河北医科大学第二医院神经内科,河北省石家庄市050000

出　　处：《中国临床康复》2004年第28期6084-6086,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:了解急性炎症性脱髓鞘性多发性神经病(acuteinflammatoryde-myelinatingpolyradiculoneuropathy,AIDP)电生理异常和受损程度的分布情况,探讨其发病机制。方法:对26例AIDP患者进行电生理检测,记录肢体两侧、上下肢及远近端运动神经末端潜伏期(DML)、运动传导速度(MCV)、肌肉复合动作电位(CMAP);感觉神经潜伏期、感觉传导速度(SCV)及肌电图。结果:①MCV异常率(78.2%)高于SCV异常率(64.1%)(χ2=5.310,P<0.05)。②肢体远端肌肉自发电位出现率(79.2%),明显高于近端肌肉(50%)(χ2=14.856,P<0.05)。③远端运动神经末端潜伏期重度受损率(75.6%),较近端神经(47.4%)高(χ2=14.628,P<0.01),远端运动神经CMAP波幅重度受损率(74.4%),较近端(52.5%)高(χ2=5.168,P<0.05)。结论:AIDP在电生理上改变为广泛的、多灶、远近端神经、上下肢均受累,运动神经较感觉神经易受累,就损伤程度而言远端神经较近端神经受损程度重。AIM:To study the distribution and lesions degree of electrophysiologal abnormalities of patients with acute inflammatory demyelinating polyradiculoneuropathy (AIDP), and explore its pathogenesis. METHODS:Twenty six patients received electrophysiological examination. The appearance of the fibrillation potential and positive sharp wave were observed. Distal motor latency(DML), motor conduction velocity(MCV), compound muscle action potential(CMAP); and sensony nerve latency, sensory conduction velocity(SCV),sensory nerve action potentials(SNAP) amplitude were recorded. RESULTS:①The abnormal rate of MCV (78.2%) was higher than that of SCV(64.1%)(χ2=5.310,P< 0.05). ②The incidence rate of fibrillation potential of distal muscles(79.2%) was obviously higher than that of proximal muscles(50%)(χ2=14.856,P< 0.05).③The severe lesion rate of DML of distal muscles (75.6%) was higher than that of proximal nerves (47.4%)(χ2=14.628, P< 0.01). The severe lesion rate of CMAP of distal nerves(74.4%) was higher than that of proximal nerves(52.5%) (χ2=5.168, P< 0.05). CONCLUSION: Electrophysiological changes of AIDP are extensive, multi focal, and its distribution is obviously abnormal on distal and proximal nerves, superior and inferior limbs. The motor nerve is easier to be damaged than sensory nerve, and the damage degree is more severe on distal nerve than proximal nerve.

关 键 词：运动神经 电生理检测 AIDP 急性炎症性脱髓鞘性多发性神经病 潜伏期 异常率 MCV 结论 意义 肌肉 

分 类 号：R745.43[医药卫生—神经病学与精神病学] R744.5[医药卫生—临床医学]