神经电生理检查在脊髓亚急性联合变性中的诊断应用  

Diagnostic value of neurological electrophysiology in subacute combined degeneration of spinal cord

作　　者：邱志茹[1,2] 刘洪波[1] 王少平[1] 张炳谦[1] 

机构地区：[1]郑州大学第一附属医院神经内科,郑州450052 [2]郑州市第一人民医院肌电图室,郑州450000

出　　处：《中国实用神经疾病杂志》2013年第9期6-8,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨神经电生理检查在脊髓亚急性联合变性(SCD)中的诊断意义。方法回顾性分析42例临床确诊为脊髓亚急性联合变性患者的病例资料,统计磁共振(MRI)检查、神经电生理检查(包括体感诱发电位、运动诱发电位、视觉诱发电位、脑干听觉诱发电位、神经传导及针肌电图)、血清维生素B12水平、症状及体征等,将神经电生理异常率与MRI异常率进行比较。结果神经电生理异常35例,异常率83.3%,其中体感诱发电位、运动诱发电位、视觉诱发电位、脑干听觉诱发电位、神经传导及针肌电图诸项目均可出现异常;MRI异常23例,异常率54.8%。通过SPSS软件处理,符合Pearsonχ2检验,差异有统计学意义(P<0.05)。结论神经电生理检查可客观反映SCD病变部位,异常率高于MRI检查,并可进行定性诊断,在SCD疾病的早期诊断中具有重要价值。Objective To explore the diagnostic value of neurological electrophysiology in subacute combined degeneration of spinal cord （SCD） diseases. Methods Totally 42 cases of clinical definite SCD patients＇information were retrospectively studied. All the examinations were registered, contained magnetic resonance image （MRI）, ne urological electrophysiology （somatosensory evoked potentials （SEP）, motion evoked potentials （MEP）, visual evoked potentials （VEP）, brainstem audi- tory evoked potentials （BAEP）, nerve conduction study （NCS） and needle electromyogram, blood serum vitamin Blz, signs and symptoms. The abnormal rate of neurological electrophysiology was compared with that of the MRI. Results Thirty-five patients had positive results in neurological electrophysiology. The positive rate was 83.3%. All of the SEP, MEP, VEP, BA- EP, NCS and needle electromyogram could be positive. Twenty-three patients＂ MRI results were positive, and the positive rate was 54.8%. Dealt with software SPSS, adjusted to the statistical test of Pearson χ2 , there was a significant difference between neurological electrophysiology and MRI （P〈0.05）. Conclusion The neurological electrophysiology examination can objectively reflect the diseased region of SCD patients. The positive rate is higher than that of MRI. We can also get a qualitative diagnosis by it. It provides significant value in the early diagnosis of SCD.

关 键 词：脊髓亚急性联合变性(SCD) 神经电生理 磁共振 体感诱发电位 运动诱发电位 

分 类 号：R741.044[医药卫生—神经病学与精神病学]