运动神经元病患者神经传导阻滞的研究  

Study of nerve conduction block in motor neuron disease

作　　者：徐迎胜[1] 樊东升[1] 郑菊阳[1] 张俊[1] 张朔[1] 康德宣[1] 

机构地区：[1]北京大学第三医院神经内科,北京100083

出　　处：《中华物理医学与康复杂志》2005年第4期224-226,共3页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的　探讨运动神经元病(MND)患者神经传导阻滞(CB)的诊断标准。方法　对86例确诊的MND患者(MND组)、60例正常人(正常组), 14例多灶性运动神经病患者(MMN组)分别进行运动神经传导速度(MCV)测定,采用由近端至远端分段刺激,记录各段刺激引发的复合肌肉动作电位(CMAP)的波幅、时限、面积,并根据不同的诊断标准判定CB。结果　MND组中,根据美国电诊断医学会(AAEM)标准有10条神经存在CB(3% ),传统标准有2条神经存在CB(0. 5% ), GustavPfeiffer标准无神经存在CB;MMN组在各种标准下均存在CB(阳性率分别为96. 4%, 89. 3%, 83. 9% );正常组均无CB。结论　对MND患者进行CB判定时,根据CMAP波幅的不同,所采用的标准也应不同。Objective To explore the diagnostic criteria of conduction block ~CB) in patients with motor neuron disease ~MND). Methods Detailed electrophysiologic studies were performed with 86 cases of defined MND, 60 healthy subjects and 14 patients with multifocal motor neuropathy^MMN). Motor conduction velocity ~MCV) studies were done segmentally by stimulating the nerve distally as well as proximally. The amplitude, duration and area of compound muscle action potentials ~CMAP) was recorded and analyzed. The values obtained from the distal and proximal ends were compared to ascertain the presence of conduction block ~CB). CB was defined with different criteria. Results According to the AAEM criteria, CB was present in 10 patients with MND(3%), but only 2 patients(0.5%) were with CB if the traditional criteria was adopted. There was no patient with CB if the criterion designed by Gustav Pfeiffer was adopted. There were CBs in patients with MMN on the basis of all three criteria that accounted for 96.4%,89.3%,83.9%, respectively, while healthy subjects showed no CB at all. Conclusion Different criteria should be adopted to determine if CB exists when the amplitude of the CMAP was taken into account.

关 键 词：神经传导阻滞 运动神经元病 患者 运动神经传导速度 多灶性运动神经病 肌肉动作电位 诊断标准 MND CMAP 正常组 CB 正常人 医学会 电诊断 阳性率 MMN 波幅 

分 类 号：R744.8[医药卫生—神经病学与精神病学]