23例肌萎缩侧索硬化症患者喉肌电图的特点  

The Laryngeal Electromyography Features of 23 Patients with Amyotrophic Lateral Sclerosis

作　　者：谢华顺[1] 马芙蓉[1] 樊东升[2] 王丽平[1] 闫燕[1] 郑菊阳[2] 鹿培泉[1] 张绍兴[1] 

机构地区：[1]北京大学第三医院耳鼻咽喉头颈外科,北京100191 [2]北京大学第三医院神经内科

出　　处：《听力学及言语疾病杂志》2013年第4期342-345,共4页Journal of Audiology and Speech Pathology

摘　　要：目的分析肌萎缩侧索硬化症(amyotrophic lateral sclerosis,ALS)患者喉肌电图的特点。方法对23例临床确诊的肌萎缩侧索硬化症(以球部症状起病8例,以肢体症状起病15例)并伴有球部症状和/或声嘶表现的患者的右侧环甲肌、甲杓肌及环杓后肌进行喉肌电图检测,分析其结果。结果共检测了23例患者69块喉内肌的肌电图,其中10例患者共11块肌肉表现为典型的失神经支配,存在纤颤、正锐波、多相运动单位电位、巨大的再生电位等;环甲肌异常率最高,异常率为43.48%(10/23),仅1例患者表现为甲杓肌异常,环杓后肌未见异常肌电图表现;球部起病患者异常率为75.0%(6/8),肢体起病患者异常率为26.67%(4/15),前者高于后者,差异有统计学意义(P<0.05)。不同性别、是否有球部症状、是否有呛咳症状患者的喉肌电图异常率比较差异无统计学意义。结论部分ALS患者喉内肌肌电图有失神经支配表现,球部起病患者的喉肌受累率高于肢体起病患者;环甲肌受累最多。Objective To detect the laryngeal electromyography（LEMG）features of the patients with amyotrophic lateral sclerosis（ALS）.Methods Twenty three ALS patients with bulbar symptom and/or hoarse were included for standard LEMG of cricothyroid muscle,thyroarytenoid muscle and posterior cricoarytenoid.Results Of 23patients with 69muscles included,10cases with 11muscles presented classic denervation characteristics,such as fibrillation potential,positive sharp wave,and polyphasic motor unit action potential.Ten of 23cricothyroid muscles were found abnormal,with only 1thyroarytenoid muscle being abnormal,and no thyroarytenoid muscle being abnormal.Six old of 8（75%）bulbar onset ALS patients presented abnormal LEMG,and 4of 15（26.67%）for limb onset ALS patients.The difference was significant（P0.05）.Other factors such as sex,bulbar symptom,and bucking made no difference to the abnormal LEMG rate.Conclusion The LEMG of patients with ALS did show abnormal.More laryngeal muscles were affected in patients with bulbar onset than limb onset.Cricothyroid muscle had more denervation changes amrg all intrinsic laryngeal muscles.

关 键 词：肌萎缩侧索硬化症 运动神经元病 喉肌电图 

分 类 号：R767.04[医药卫生—耳鼻咽喉科]