皮肤交感反射、肛门括约肌肌电图和瞬目反射在帕金森病诊断中的应用  

Application of skin sympathetic reflex,anal sphincter electromyography and blink reflex in the diagnosis of Parkinson’s disease

作　　者：韦倩娜 林诗映 王玲[1] WEI Qian-na;LIN Shi-ying;WANG Ling(Department of Neuroelectrophysiology, Jinhua Central Hospital, Jinhua 321000, China)

机构地区：[1]金华市中心医院神经电生理科

出　　处：《基础医学与临床》2019年第11期1607-1611,共5页Basic and Clinical Medicine

摘　　要：目的探讨皮肤交感反射(SSR)、肛门括约肌肌电图(EAS-EMG)和瞬目反射在帕金森病(PD)诊断中的应用价值。方法选择金华市中心医院收治的帕金森病患者50例,根据患者的神经功能评估情况,将其分为无自主神经功能障碍(PD-NAS)组(35例)和自主神经功能障碍(PD-AS)组(15例)。另选择50名同期健康体检者作为对照组。对两组进行帕金森病自主神经症状评分(SCOPA-AUT),同时检测两组的皮肤交感反射、肛门括约肌肌电图和瞬目反射情况,分析帕金森病自主神经症状评分与皮肤交感反射、瞬目反射和肛门括约肌肌电图之间的相关性。结果 PD-AS组SCOPA-AUT平均得分显著高于PD-NAS组(P<0. 05),亦显著高于对照组(P<0. 05)。PD-AS组患者皮肤交感反射(SSR)与对照组相比,潜伏期延长、波幅降低(P<0. 05)。PD-AS组肛门括约肌轻微收缩时运动单位(MUAP)的平均时限和多相百分比与PD-NAS组相比显著提高(P<0. 05)。PD-AS组较PD-NAS组瞬目反射R2、R2’波潜伏期延长(P<0. 05)。PD-AS组上下肢SSR波幅与上下肢的SSR潜伏期呈正相关(P<0. 05)。SCOPA-AUT得分与MUAP的平均时限和多相波百分比呈正相关(P<0. 05)。结论皮肤交感反射、瞬目反射和肛门括约肌肌电图能够反应帕金森病患者自主神经功能障碍的严重程度,能够为帕金森病的早期诊断提供依据。Objective To investigate the value of skin sympathetic reflex(SSR), anal sphincter electromyography(EAS-EMG) and blink reflex in the diagnosis of Parkinson s disease. Methods Fifty patients with Parkinson s disease were selected from Jinhua Central Hospital, according to the evaluation of neurologic function, the patients were divided into two groups: no autonomic nerve dysfunction (PD-NAS) group(thirty-five cases)and autonomic nervous dysfunction (PD-AS) group (fifteen cases). Another fifty healthy health examiners were selected as the control group. Parkinson s autonomic symptoms were scored in all groups, and skin sympathetic reflex, anal sphincter electromyography and blink reflex were measured at the same time. The correlation between Parkinson s autonomic symptom score and skin sympathetic reflex, blink reflex and anal sphincter electromyograms were analyed. Results The average score of SCOPA-AUT in PD-AS group was significantly higher than that in PD-NAS group ( P <0.05), and it was also significantly higher than that in control group ( P <0.05). The skin sympathetic reflex (SSR) of patients in PD-AS group was prolonged the latency and decreased the amplitude as compared with the control group ( P <0.05). The mean time and polyphasic percentage of motion unit of anal sphincter during slight contraction(MUAP) in PD-AS group were significantly higher than those in PD-NAS group( P <0.05). In the PD-AS group, the latency of R2 and R2′ waves was longer than that of the PD-NAS group ( P <0.05). In PD-AS group, the amplitude of SSR in upper and lower extremities was positively correlated with the latency of SSR in the upper and lower extremities ( P <0.05), and the SCOPA-AUT score was positively correlated with the average duration of MUAP as well as the percentage of multiphase waves ( P <0.05). Conclusions Skin sympathetic reflex, blink reflex and anal sphincter EMG can reflect the severity of autonomic dysfunction in patients with Parkinson s disease and provide a basis for early diagnosis of Parkinson s dis

关 键 词：帕金森病 皮肤交感反射 肛门括约肌肌电图 瞬目反射 

分 类 号：R443.8[医药卫生—诊断学]