甲亢性神经肌肉病变的临床及电生理研究  

Clinical and electrophysiologic study in patients with nerve myopathy related to hyperthyroidism

作　　者：田淑芬[1] 刘勇 楚兰[1] 

机构地区：[1]贵阳医学院附属医院神经内科,贵州贵阳550004 [2]河南省商丘市第三人民医院神经内科,河南商丘476000

出　　处：《中风与神经疾病杂志》2011年第1期25-28,共4页Journal of Apoplexy and Nervous Diseases

基　　金：贵州省科学技术基金项目([2009]2163)

摘　　要：目的观察甲状腺功能亢进症(甲亢)患者神经系统病变特点及电生理的改变,探讨电生理在甲亢性神经肌肉病变中的应用价值。方法对60例甲亢患者行神经系统病史询问及体格检查;行针极肌电图、神经传导测定;部分行神经重复电刺激检测。结果 60例甲亢患者出现不同的神经肌肉症状;部分患者的肌电图出现异常,表现运动单位动作电位(MUAPs)时限缩短、多相波增多、波幅降低、干扰相、病理干扰相等,尤以(MUAPs)时限缩短明显。轻收缩时MUAPs时限缩短的发生率男性患者高于女性,且与病程长短无关。少部分出现周围神经的损害,主要以感觉传导异常为主,见于病程较长的患者。结论甲亢患者中部分病例可出现神经肌肉损害,电生理可协助诊断;同时电生理还可检测亚临床甲亢性肌病和神经病变,MUAPs时限改变为肌肉受损较敏感和客观的指标之一。Objective To observe the nervous system pathological characteristics and electrophysiological changes in hyperthyroidism patients and to explore the clinical applicable value of electrophysiology in patients with nerve myopathy re- lated to hyperthyroidism. Methods Sixty patients with hyperthyroidism were carried out with intimate inquest for nervous system case history and physical check-up. Nerve conduction（NC） and electromyography（EMG） were done in all patients. Part of the patients were given nerve replicate stimulation detection. Results Sixty patients appeared various nervous system pathological manifestation. EMG of part of the patients was abnormal, which manifested as follows ： shortened duration of motor unit action potential（MUAPs） ,increased multi-phase wave, short amplitude of wave, interfered phase, pathologic interference phase etc. The shortened duration of MUAPs was especially obvious. The occurrence rate of shortened MUAPs duration in males was higher significantly than that in females when lightly shrinking. But it did＇ t have a matter with course of disease length. Small part of the patients that had a very long course of the disease appeared peripheral nervous damage, which manifestation was mostly abnormal feeling conduction. Conclusion Patients with hyperthyroidism may appear nervemuscle damage, and the use of electrophysiology can assist to diagnose. Meanwhile, electrophysiology can also detect subclinical hyperthyroidism myopathy and neuropathy. Changes in duration of MUAPs might be a more sensitive and objective index of muscle damage.

关 键 词：甲状腺功能亢进症 甲亢性神经肌肉病 肌电图 神经传导 

分 类 号：R581.1[医药卫生—内分泌] R746[医药卫生—内科学]