复合肌肉动作电位与周围神经损伤程度的相关性研究  

CORRELATION STUDY BETWEEN COMPOUND MUSCLE ACTION POTENTIAL AND THE DEGREE OF PERIPHERAL NERVE INJURY

作　　者：白雪[1] 于绍斌[1] 朱玲[1] 朱琳[1] 邸旭辉[1] 马银霞[1] 

机构地区：[1]河北医科大学第三医院肌电图室,050051

出　　处：《现代电生理学杂志》2013年第3期142-145,共4页Journal of Modern Electrophysiology

摘　　要：目的:分析45例腓总神经不全损伤患者复合肌肉动作电位(CMAP)的波幅、时程,探讨其与周围神经损伤程度的关系。方法 :选择2012年1月至2012年12月就诊于我院的45例不同程度腓总神经不全损伤患者,根据患者胫前肌肌力级别将45例患者分为三组(n=15):胫前肌肌力4-5级(P_1组)、胫前肌肌力2-3级(P_2组)、胫前肌肌力1级(P_3组)。应用肌电诱发电位仪记录45例患者的CMAP波形,测量CMAP波幅与时程。采用SPSS13.0统计软件对数据进行秩和检验,分析各组间CMAP波幅与时程的差别。结果 :(1)P_1组、P_2组和P_3组腓总神经-胫前肌CMAP平均波幅分别为7.1±0.2mv、3.3±0.3mv和0.5±0.1mv;P_2组、P_3组与P_1组相比,波幅均有显著性差异(P<0.05);P_3组与P_2组相比,波幅亦有显著性差异(P<0.05)。(2)P_1组、P_2组和P_3组腓总神经-胫前肌CMAP平均时程分别为11.4±0.4ms、16.9±0.6ms和23.3±1.2ms;P_2组、P_3组与P_1组相比,时程均有显著性差异(P<0.05);P_3组与P_2组相比,时程亦有显著性差异(P<0.05)。结论 :(1)CMAP波幅、时程有助于评价周围神经受损的严重程度。(2)CMAP波幅降低提示有功能的周围神经轴突数量减少,时程延长反映了周围神经的脱髓鞘损害。ObjectiVe： To analyze the amplitude and duration of CMAP of 45 patients with incomplete peroneal nerve injury and investigate the relationship between CMAP and the degree of peripheral nerve injury. Methods： 45 patients with different degree of incomplete peroneal nerve injury from January 2012 to December 2012 were selected. 45 patient were divided into three groups （n= 15） according to the levels of tibialis anterior muscle strength： muscle strength grade 4-5 （ group Pl ） , muscle strength grade 2~3 （ group P2 ） , muscle strength grade 0-1 （ group P3 ） . The CMAP waveforms of all the patients were recorded and the amplitudes and durations were measured using EMG/EP instrument. The CMAP amplitude and duration datas of three groups were analyzed through rank sum test using SPSS13.0 statistical software. Results： （ 1 ） The mean peroneal nerve -tibialis anterior muscle CMAP amplitudes of group P1, P2 and P3 were 7.1 ± 0.2mv, 3.3 ± 0.3mv and 0.5 ± 0.1mv respectively. Compared with group P1, the CMAP amplitudes of group P2 and P3 were significantly different （P 〈0.05 ） . Compared with group P2, the CMAP amplitude of group P3 was significantly different （P〈0.05 ） . （ 2 ） The mean peroneal nerve - tibialis anterior muscle CMAP durations of group P1, P2 and P3 were 11.4 ± 0.4ms, 16.9 ± 0.6ms and 23.3 ± 1.2ms respectively. Compared with group P1, the CMAP durations of group P2 and P3 were significantly different （P 〈0.05 ） . Compared with group P2, the CMAP duration of group P3 was significantly different （P 〈0.05 ） . Conclusions： （ 1 ） CMAP amplitude and duration are conducive to evaluate the severity of peripheral nerve injury. （ 2 ） The decreased CMAP amplitude suggests the axon number reduction of functional peripheral nerves and the prolonged CMAP duration reflects the demyelination damage of peripheral nerves.

关 键 词：腓总神经损伤 复合肌肉动作电位 轴突 髓鞘 

分 类 号：R651.3[医药卫生—外科学]