经颏下超声测量成人舌肌厚度参考值及其初步应用  

Establishment of reference values of tongue muscle thickness with ultrasonography measurement and evaluation of tongue fasciculation through the submental way in Chinese healthy adults and its clinical application

作　　者：宋红松[1] 樊东升[1] 王宏利[1] 刘娜[1] 

机构地区：[1]北京大学第三医院神经内科,100191

出　　处：《中华神经科杂志》2017年第11期837-841,共5页Chinese Journal of Neurology

摘　　要：目的 建立经颏下超声测量健康成人舌肌厚度和评价舌肌纤颤的方法,获得舌肌厚度的正常值及其范围,并探讨其在肌萎缩侧索硬化（ALS）临床诊断中的应用价值.方法 对2016年10—12月于北京大学第三医院体检中心体检的200名健康成人采用3.5 MHz凸阵探头在冠状面测量通过垂直于冠状位法兰克福平面的切面中央处、舌肌上下表面之间的距离;在相同体位应用7.5 MHz线阵探头观察舌肌纤颤情况.应用此法测量同一时期就诊于神经内科门诊的30例确诊或拟诊级别ALS患者的舌肌厚度并观察舌肌纤颤情况.选取30名年龄和性别与ALS患者相匹配的健康成人,比较健康成人和ALS患者舌肌厚度的差异.结果 男性受检者舌肌厚度[（4.09＆#177;0.52）cm]明显大于女性与[（3.70＆#177;0.56）cm,t=5.108,P〈0.01],但各年龄组健康成人舌肌厚度之间差异无统计学意义;舌肌厚度与受检者的体重指数显著相关（r=0.412,P〈0.01）;全部健康对照者均未检测到舌肌纤颤.ALS患者舌肌厚度[（3.77＆#177;0.58）cm]明显小于健康对照者[（4.05＆#177;0.49）cm,t=-0.253,P〈0.05）.30例ALS患者中有12例（40%）可见舌肌纤颤.结论 经颏下超声测量舌肌厚度和评估舌肌纤颤的方法稳定可靠,在相关疾病如ALS中具有良好的临床应用价值.Objective To establish a method which could measure tongue muscle thickness and evaluate the fasciculation of the tongue muscle by submental way ultrasonic detection , and to obtain the reference values of tongue muscle thickness in healthy volunteers , exploring its clinical application in the patients with amyotrophic lateral sclerosis （ALS）.Methods In two-hundred healthy volunteers who took physical examination at the Medical Examination Center of Peking University Third Hospital , the tongue thickness was determined by measuring the distance between the upper and lower surfaces of the lingual muscles in the center of the plane perpendicular to the Frankfurt horizontal plane of the frontal section with a 3.5 MHz convex array transducer .The fasciculation of tongue muscle was evaluated using a 7.5 MHz linear array transducer in the same position .This method was used to measure the thickness of tongue muscle and to evaluate tongue muscle fasciculation in 30 patients with ALS who visited neurological clinic with the diagnosis of possible or definite ALS according to revised El Escorial criteria during the same period .We compared the tongue muscle thickness between 30 ALS patients and the same number of age-and gender-matched healthy volunteers .Results The mean value of tongue muscle thickness of males was significantly higher than that of females （（4.09 ＆#177;0.52） cm vs （3.70 ＆#177;0.56） cm, t=5.108, P〈0.01）, but there was no significant difference in the tongue muscle thickness between the different age groups .The mean value of tongue muscle thickness was significantly correlated with the body mass index value in healthy subjects （ r=0.412, P〈0.01）.No tongue muscle fibrillation was detected in healthy volunteers .In ALS group, the tongue was significantly thinner than that in healthy subjects （（3.77 ＆#177;0.58） cm vs （4.05 ＆#177;0.49） cm, t=-0.253, P〈0.05）.Of the total 30 ALS patients, we recognized tongue muscle fasciculation in 12 （40%）.Conclusion The meth

关 键 词：舌 超声检查 参考值 肌束震颤 肌萎缩侧索硬化 

分 类 号：R445.1[医药卫生—影像医学与核医学]