颏下肌群表面肌电信号评定脑卒中患者吞咽障碍的价值  

The value of submental muscle surface electromyography signal for evaluating dysphagia in stroke patients

作　　者：孙全义[1] 陈雪丽[1] 李春梅[1] 黄玉琦 Sun Quanyi;Chen Xueli;Li Chunmei;Huang Yuqi(Department of Rehabilitation,Beijing Geriatric Hospital,Beijing 100095,China)

机构地区：[1]北京老年医院康复科

出　　处：《广西医科大学学报》2019年第7期1104-1107,共4页Journal of Guangxi Medical University

基　　金：北京市属医院科研培育计划课题资助项目(No.PX2018081)

摘　　要：目的:探讨颏下肌群表面肌电信号评定脑卒中患者吞咽障碍的价值。方法:选取2016年11月至2018年10月北京老年医院康复科收治的60例脑卒中患者,根据标准吞咽功能评估量表筛查和视频吞咽造影检查结果分为吞咽障碍组(34例)和无吞咽障碍组(26例),同期选取30例健康志愿者作为健康对照组。3组均进行颏下肌群表面肌电测试,记录空吞咽、吞咽5mL温水与吞咽10mL温水时双侧颏下肌群表面肌电的最大振幅、平均振幅、吞咽时限并进行比较。绘制受试者工作特征(ROC)曲线,观察空吞咽时最大振幅、平均振幅、吞咽时限诊断吞咽障碍的最佳界值。结果:吞咽障碍组空吞咽、吞咽5mL温水及吞咽10mL温水时最大振幅、平均振幅均大于其他两组,吞咽时限长于其他两组(均P<0.05),而无吞咽障碍组与健康对照组比较,差异无统计学意义(P>0.05)。空吞咽时最大振幅、平均振幅、吞咽时限诊断吞咽障碍的最佳界值分别为50.5μV、21.5μV、2.25s,ROC曲线下面积分别为0.850、0.954、0.895,灵敏度分别为0.878、0.972、0.845,特异度分别为0.801、0.953、0.956。结论:表面肌电图技术可作为脑卒中患者吞咽障碍评估的有效手段。Objective: To explore the value of submental muscle group surface electromyography (SMG) signal in evaluating dysphagia in stroke patients. Methods: A total of 60 stroke patients were enrolled from November 2016 to October 2018.The patients were divided into dysphagia group (34 cases) and non-dysphagia group (26 cases) according to the results of video fluoroscopic swallowing study and standard screening of aphagia,and 30 healthy subjects were defined as healthy controls.The SMG of the infraorbital muscle group was performed.The maximum amplitude,average amplitude and time of onset of the surface myoelectricity of the bilateral infraorbital muscles when swallowing,swallowing 5 L of warm water and swallowing 10 mL of warm water were recorded and compared.The ROC curve was drawn to observe the best threshold values of maximum amplitude,average amplitude and swallowing time for the diagnosis of dysphagia. Results: The maximum amplitude,mean amplitude,and time of swallowing in dysphagia group who swallowed,swallowed 5 mL of warm water and swallowed 10 mL of warm water were higher than those in the non-swallowing group and the healthy control group ( P <0.05).There was no significant difference between the non-dysphagia group and healthy control group ( P >0.05).The optimal thresholds of the maximum amplitude,the average amplitude,time of swallowing for the diagnosis of dysphagia were 50.5 μV,21.5 μV and 2.25 seconds.The area under the ROC curve was 0.850,0.954,0.895,respectively,sensitivity was 0.878,0.972,0.845,respectively,and specificity was 0.801,0.953,0.956,respectively. Conclusion: The surface EMG technology can be used as an effective evaluation method for dysphagia in stroke patients.

关 键 词：脑卒中 吞咽障碍 颏下肌群 表面肌电信号 

分 类 号：R743.3[医药卫生—神经病学与精神病学]