颈胸髓损伤患者H反射测定值与痉挛的关系研究  

Relation between H Reflex and Spasticity after Cervical or Thoracic Spinal Cord Injury

作　　者：熊国星[1,2] 洪毅[2] 张军卫[2] 刘亚东[3] 陈世铮[2] 关骅[2] 

机构地区：[1]首都医科大学公共卫生与家庭医学学院康复医学教研室,北京市100069 [2]中国康复研究中心脊柱脊髓外科,北京市100068 [3]北京潞河医院骨科,北京市101100

出　　处：《中国康复理论与实践》2010年第6期563-565,共3页Chinese Journal of Rehabilitation Theory and Practice

摘　　要：目的探讨完全性颈胸髓损伤后H反射相关值的变化及其定量评价痉挛的程度。方法对13例健康成人(对照组)和30例脊髓损伤患者(亚急性期18例,慢性期12例)进行两次比目鱼肌H反射测定,两次之间相隔1个月,对患者同时运用改良Ashworth肌张力评定分级进行痉挛评估。结果通过比目鱼肌H反射检测,各阶段脊髓损伤患者Hmax/Mmax比、最大H波波幅无显著性差异(P>0.05),但波幅均较健康成人明显减小(P<0.01)。脊髓损伤亚急性期痉挛程度与最大H波波幅、Hmax/Mmax比均呈quadratic关系(P<0.05),慢性期后两者间呈线性关系(P<0.05)。结论脊髓损伤后比目鱼肌Hmax/Mmax比与痉挛有密切的关系,但它们之间的定量关系还需要更大样本来证实。Objective To investigate the changes and relevance of H reflex and spasticity after cervical or thoracic spinal cord injury （SCI）.Methods H reflex of 13 healthy adults as controls and 30 SCI patients （subacute,n=18;chronic,n=12） was measured twice from soleus muscle once a month.In the same time,the evaluation of spasm was performed by the modified Ashworth scale.Results There was no significant difference in the mean Hmax amplitude and Hmax/Mmax ratio between different SCI stages（P〉0.05）.However,the mean Hmax amplitude of the patients was smaller than that of controls（P〈0.01）.During subacute stage there was quadratic correlation between the mean Hmax amplitude and spasticity,Hmax/Mmax ratio and spasticity.But there was linear correlation between Hmax/Mmax ratio and spasticity during chronic stage.Conclusion There was closer relation between spasticity and Hmax/Mmax ratio after spinal cord injury.However,the quantitative evaluation need to be proved by larger samples.

关 键 词：脊髓损伤 H反射 Hmax/Mmax比 改良Ashworth量表 

分 类 号：R651.2[医药卫生—外科学]