甲状腺功能减低性肌病的临床和肌电图研究  

The Clinical and Electromyographic Study on Hypothyroid Myopathy

作　　者：吕安坤[1] 朱建红[1] 祁建国[1] 张震中[1] 

机构地区：[1]新疆医科大学附属中医医院,新疆乌鲁木齐市830000

出　　处：《中国全科医学》2010年第30期3381-3382,3385,共3页Chinese General Practice

摘　　要：目的观察甲状腺功能减低性肌病(甲减性肌病)患者的肌电图变化特点,探讨甲减性肌病与三碘甲状腺原氨酸(T3)水平、甲状腺素(T4)水平、病程、肌力及肌酸激酶水平的关系。方法对43例甲减患者进行神经传导检查及同心圆针电极肌电图检查,并分析临床及实验室检测指标与肌电图的关系。结果 43例甲减患者感觉、运动神经传导速度及波幅均在正常范围内;共有21例(48.8%)符合甲减性肌病诊断,肌电图显示以短时限运动单位为主的肌源性损害,且其三角肌的异常率(48.8%)显著高于股内肌(28.9%),差异有统计学意义(P<0.01)。甲减患者的病程延长、T3及T4水平降低、肌力下降、肌酸激酶水平升高均造成其运动单位时限异常率上升(P<0.05)。结论甲减患者尽早完成肌电图检查可发现亚临床甲减性肌病的存在;运动单位时限是评估甲减性肌病较为客观及敏感的指标,其变化与T3、T4水平,病程,肌力,肌酸激酶水平有关,可用来监测甲减患者的疾病进展状况。Objective To observe the EMG characteristics of the hypothyroid myopathy patients,and discuss the relationship between the hypothyroid myopathy and the T3,T4 levels,the course of illness,the muscle strength,the level of creatine kinase.Methods Adopt the nerve conduction check and needle electrode EMG technique to detect 43 patients of hypothyroid,and analyse the relationship between the clinical and laboratory parameters and the EMG.Results 43 Hypothyroid patients＇ perceive,move nerve conduction speed and amplitude is within regular range.There were 21 （48.8%） cases accord with the diagnose of hypothyroid myopathy,the EMG showed that the short time limit exercise unit was the main muscle source damage and the abnormal degree of the deltoid （48.8%） was obviously more than vastus medialis（28.9%）,the difference was significant （P0.01）;The extension of illness course,the decrease of T3 T4 levels and muscle strength and the increasing of creatine kinase in the hypothyroid patients will all make the abnormality rate of the exercise unit time limit rise（P0.05）.Conclusion The hypothyroid patient should have the EMG check as early as possible to find the existence of subclinical hypothyroid myopathy,the exercise unit time limit is the more objective and sensitive index to evaluate the hypothyroid myopathy,and it is associated with the T3,T4 levels,the course of illness,the muscle strength and the level of creatine kinase,and it can monitor the disease development of hypothyroid patient.

关 键 词：甲状腺功能减退症 肌疾病 肌电描记术 

分 类 号：R581.2[医药卫生—内分泌]