脊髓传导速度在脊髓亚急性联合变性病中对脊髓病变的诊断意义  

Diagnostic significance of spinal cord conduction velocity in the diagnosis of central lesions in subacute combined degeneration

作　　者：贾志荣[1] 王亭亭[1] 潘涛[1] 王洪霞[2] 石昕[1] 梁为[1] 

机构地区：[1]北京大学第一医院神经内科,100034 [2]苏州大学第一附属医院神经内科

出　　处：《中华医学杂志》2011年第37期2641-2643,共3页National Medical Journal of China

摘　　要：目的探讨脊髓传导速度（sccv）测定在诊断脊髓亚急性联合变性（SCB）病中脊髓病变的临床应用价值，初步探讨该方法在脊髓病变中的定位价值。方法对北大医院2005--2010年临床确诊的脊髓亚急性联合变性病患者分别进行脊髓传导速度（SCCV）测定、躯体感觉诱发电位（SEP）检查、脊髓核磁（MRI）检查，将SCCV的结果与健康对照组比较并进行统计学分析，同时将SCCV结果与SEP和脊髓MRI结果进行比较。结果共22例患者，男16例，女6例，年龄28～84岁，平均（56±13）岁。所有SCD患者均行SCCV测定和脊髓核磁检查，18例患者同时行SEP检查。其中SCCV异常率为81．8％（18／22），脊髓MRI异常率为13．6％（3／22），SEP异常率为72．2％（13／15）。3例MRI异常患者中，其诱发电位结果均异常。19例MRI正常患者中18例SCCV结果异常。13例SEP异常的患者中，其SCCV结果均异常。5例SEP正常的患者中5例SCCV结果异常。结论SCCV可以客观地记录SCD脊髓病变早期异常的电生理改变，异常率比脊髓核磁异常率高，且可以协助定位，其为SCD患者早期脊髓病变提供了可靠的客观诊断依据。Objective To study explore the roles of spinal cord conduction velocity （SCCV） test in the diagnosis of spinal lesions in patients with subaeute combined degeneration （ SCD ） of spinal cord and examine the values of SCCV in the localization of spinal lesions. Methods A total of 22 SCD patients recruited from 2005 to 2010 at our hospital underwent the SCCV test, the somatosensory evoked potential （SEP） test and MRI in spinal cord respectively. The results of SCCV were compared with those of SEP and MRI. Results There were 16 males and 6 females with an average age of （56 ± 13） years old （range： 28- 84）. All SCD patients underwent the examinations of SCCV and spinal MRI. And 18 patients received the test of SEP. The abnormalities of SCCV test were 81.8% （18/22） and those of MRI and SEP 13.6% （3/22）and 72. 2% （13/15）respectively. The results of SCCV and spinal MRI were both abnormal in 3 patients. Nineteen patients had normal MRI while 18 had abnormal SCCV results. Conclusion The early eleetrophysiological abnormalities in spinal cord of SCD patients may be detected objectively by SCCV. They appear earlier than those of pathological and imaging findings. The abnormal rates of SCCV are much higher than those of spinal MRI. The SCCV test can also help to localize the lesions in spinal cord of SCD patients. It may provide an objective diagnostic basis for the lesions of spinal cord of SCD patients at an early stage.

关 键 词：脊髓亚急性联合变性 磁共振成像 电生理学 脊髓传导速度 

分 类 号：R744[医药卫生—神经病学与精神病学]