平山病的神经电生理特点  

Electrophysiological Characteristics of Hirayama Disease

作　　者：汪柳霞[1] 郑维红[1] 

机构地区：[1]厦门大学附属中山医院神经内科,福建厦门361004

出　　处：《中外医疗》2016年第36期187-189,共3页China & Foreign Medical Treatment

摘　　要：目的分析平山病的神经电生理特点,以提高对该病的诊断水平。方法方便选取2009年2月—2014年1月在该院中就诊的20例平山病患者为研究对象,进行神经传导及针极肌电图检测,观察感觉神经传导、运动神经传导情况,针极肌电图表现,对比单侧发病患者患肢、健肢正中神经与尺神经的CAMP波幅、DML、ADM/APB。结果 20例患者中,均具正常SCV、SNAP波幅。8例尺神经DML延长,4例正中神经DML延长,1例桡神经DML延长;18例尺神经CMAP波幅降低,11例正中神经CMAP波幅降低,5例桡神经CMAP波幅降低。20例均患侧颈7,8～胸1节段支配肌异常,2例同时累及颈7节段支配肌;17例对侧上肢颈8～胸1节段支配肌异常,11例同时累及颈7节段支配肌。11例单侧发病患者中,患肢正中神经CMAP波幅（7.75±1.86）m V、DML（4.07±0.54）ms,尺神经CMAP波幅（3.75±2.45）m V、DML（3.45±0.38）ms,ADM/APB（0.48±0.32）;健肢正中神经CMAP波幅（10.27±1.17）m V、DML（3.72±0.23）ms,尺神经CMAP波幅（10.46±1.99）m V、DML（2.80±0.29）ms,ADM/APB（1.04±0.24）。患肢正中神经、尺神经CMAP波幅,ADM/APB低于健肢,正中神经、尺神经DML高于健肢,差异有统计学意义（P〈0.05）。结论平山病的神经电生理学特点可为该病提供有助于定位诊断和鉴别诊断的依据。Objective To analyze the electrophysiological characteristics of Hirayama disease, in order to improve the diagnostic level of the disease. Methods Convenient selection in February 2009 to January 2014 in our hospital clinic of 20 cases of hirayama disease as the research object, on nerve conduction and needle electromyography detection,the changes of sensory nerve conduction, motor nerve conduction and needle electromyography（EMG） were compared between the limbs of the patients with unilateral disease, CAMP amplitudes of median nerve and ulnar nerves, DML, ADM/APB. Results20 patients, all with normal SCV, SNAP amplitude. 8 cases of ulnar nerve DML prolonged, 4 cases of median nerve DML prolonged, 1 case of radial nerve DML prolonged; 18 cases of ulnar nerve CMAP amplitude decreased, 11 cases of median nerve CMAP amplitude decreased, 5 cases of radial nerve CMAP amplitude decreased. 20 cases were affected side 7,8 ～thoracic segment 1 control muscle abnormalities, 2 cases involving the neck 7 section of the muscle control; 17 contralateral upper limb neck 8 ～ thoracic 1 segment dominated muscle abnormalities, 11 cases involving the neck at the same time 7segments dominate the muscle. The mean CMAP amplitude（7.75 ± 1.86） m V, DML（4.07 ± 0.54） ms, the amplitude of CMAP of the ulnar nerve（3.75 ± 2.45） m V, DML（3.45 ± 0.38） ms, ADM/APL（0.48 ± 0.32）, median nerve CMAP amplitude（10.27 ± 1.17） m V, DML（3.72 ± 0.23） ms, ulnar nerve CMAP amplitude（10.46 ± 1.99） m V, DML（2.80 ± 0.29） ms,ADM/APB（1.04 ± 0.24）. The CMAP amplitude and ADM/APB of the limb median nerve and the ulnar nerve were lower than those of the healthy limb, and the DML of the median nerve and the ulnar nerve were higher than that of the healthy limb, the difference was statistically significant（P 〈0.05）. Conclusion Hirayama disease electrophysiological characteristics can provide help to the diagnosis and differential diagnosis of localization basis for the disease.

关 键 词：平山病 神经电生理 肌萎缩 

分 类 号：R746.9[医药卫生—神经病学与精神病学]