低钾型周期性瘫痪发作间期的肌电图运动诱发试验特点  

Analysis of electromyographic exercise test in patients with hypokalemic periodic paralysis during interictal period

作　　者：董亮艳 李芳 潘宗 拓炜 陈景云 DONG Liangyan;LI Fang;PAN Zong;TUO Wei;CHEN Jingyun(Department of Neurophysiological,Cardiovascular Hospital of Ningxia Medical University,Yinchuan 750002,China)

机构地区：[1]宁夏医科大学总医院心脑血管病医院神经电生理科,银川750002 [2]宁夏医科大学总医院心脑血管病医院神经内科

出　　处：《中国神经精神疾病杂志》2018年第8期453-456,共4页Chinese Journal of Nervous and Mental Diseases

基　　金：宁夏医科大学科学研究基金资助项目(编号:XM2016074)

摘　　要：目的探讨低钾型周期性瘫痪患者肌电图运动诱发试验的特点。方法选择我院确诊为低钾型周期性瘫痪患者(包括原发性和继发于甲状腺功能亢进、肾小管酸中毒、原发性醛固酮增多症、酒精性等病因后)27例做为病例组,选择27例健康志愿者做为对照组。检测时病例组处于发作间期(血钾正常),对小指展肌进行快速剧烈运动,运动前测1次小指展肌的复合肌肉动作电位(compound muscle action potential,CMAP)波幅作为基线水平,分别于运动后即刻、运动后15 min、30 min、60 min、90 min、120 min各个时间点测量CMAP波幅,记录各个时间点的波幅变化率,进行重复测量方差分析。结果 两组间CMAP波幅变化率差异有统计学意义(P=0.000),同时发现随着测量时间的推移CMAP波幅变化率差异也有统计学意义(P=0.000),且存在组别与测量时间之间的交互效应(P=0.000)。运动后即刻两组波幅均轻度升高,波幅升高率差异无统计学意义(P=0.313),运动后15 min两组波幅均小幅度降低,波幅降低率差异仍无统计学意义(P=0.087)。对照组在30 min后波幅不再降低,波幅降低率控制在-28.9%以内,平均在90 min后回升至基线水平。病例组在30 min^120 min波幅仍持续降低,同一时间点与对照组比较差异均有统计学意义(P=0.000)。结论 肌电图运动诱发试验能为发作间期的低钾型周期性瘫痪患者的诊断提供客观依据。Objective To evaluate the characteristics of electromyography(EMG)exercise test(ET)in patients with hypokalemic periodic paralysis(HOPP).Methods Patients with HOPP(including primary and secondary hyperthyroidism,renal tubular acidosis,primary aldosteronism,alcohol and other etiological factors)were selected from our hospital.Twenty-seven patients eligible for inclusion were selected as case group and 27 healthy volunteers as control group.The case group was in interictal phase(normal blood potassium).Patients rapidly and violently exercised the abductor digiti minimi(ADM)muscle.The amplitude of compound muscle action potential(CMAP)of ADM muscle was measured before exercise as the baseline level.CMAP amplitudes of ADM muscles were measured at different time points including immediately,15min,30 min,60 min,90 min and 120 min after exercise.The change rate of amplitude was assessed at each time point and the variance analysis of repeated measurement was carried out.Results The difference of CMAP amplitude was statistically significant between the two groups.The change rate of CMAP amplitude was also significantly different over each time point.There was interaction between groups and measurement times in rate of change of CMAP(P=0.000).The amplitudes were slightly increased in both groups and there was no significant difference in the increase rate of the amplitudes between these two groups(P=0.313).The amplitudes of were marginally decreased at 15 min after exercise at these two groups and the decreasing rates were not significantly different(P=0.087).The amplitudes were no longer decreased in the control group after 30min,and the decrease range was within-28.9%and then returned to baseline level after 90 min.The amplitudes of the patients continued to decrease between 30 and 120 min in case group.The amplitudes were significantly different between the two groups at the same time point(P=0.000).Conclusion The electromyographic exercise test can provide an objective basis for the diagnosis of interictal period i

关 键 词：肌电图运动诱发试验 低钾型周期性瘫痪 发作间期 

分 类 号：R745[医药卫生—神经病学与精神病学]