应用表面肌电检测面肌痉挛异常肌反应的可行性分析  

Feasibility of using surface electromyography for the detection of abnormal muscle response in patients with hemifacial spasm

作　　者：马程文 高炀[1] 宋琴[1] 周乐[1] 徐岁云[1] 王金娟[1] 屈建强[1] 闫先侠 MA Chengwen;GAO Yang;SONG Qin;ZHOU Le;XU Suiyun;WANG Jinjuan;QU Jianqiang;YAN Xianxia(Department of Neurosurgery,The Second Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710004,China)

机构地区：[1]西安交通大学第二附属医院神经外科,陕西西安710004

出　　处：《西安交通大学学报（医学版）》2021年第6期929-934,共6页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：国家自然科学基金青年项目(No.81801121);陕西省科技统筹创新工程计划项目(No.2016KTCL03-08);陕西省重点研发计划项目(No.2017SF-026)。

摘　　要：目的评估应用表面肌电检测面肌痉挛患者异常肌反应(AMR)的可行性。方法回顾性分析2019年6月至2020年12月在西安交通大学第二附属医院接受显微血管减压手术治疗的原发性面肌痉挛(HFS)患者的临床资料,纳入同时接受应用表面电极(术前)和针电极(术中)检测AMR的面肌痉挛患者。选择颧支-颏肌和下颌缘支-眼轮匝肌两组刺激-记录位点的检测结果,分析AMR的特征,对比两种电极测得AMR的阳性率。结果研究最终纳入77例患者。应用表面电极在颧支-颏肌测得AMR阳性率为90.9%(70/77),潜伏期为(10.87±1.86)ms,波幅为(202.8±47.4)μV;在下颌缘支-眼轮匝肌测得AMR的阳性率为92.2%(71/77),潜伏期为(10.41±1.83)ms,波幅为(211.1±54.1)μV。两组刺激-记录位点总共在74例(96.1%)患者中检测到AMR,且测得的AMR的阳性率、潜伏期和波幅均没有统计学差异。应用针电极在颧支-颏肌测得AMR的阳性率为98.7%(76/77),显著高于在下颌缘支-眼轮匝肌测得的89.6%(69/77),差异具有统计学意义(P=0.016)。颧支-颏肌测得的AMR潜伏期为(10.63±1.39)ms,波幅为(83.5±27.2)μV;下颌缘支-眼轮匝肌测得的AMR潜伏期为(10.31±1.18)ms,波幅为(58.6±21.4)μV。两组刺激-记录位点测得的潜伏期没有统计学差异,但下颌缘支-眼轮匝肌测得的波幅更低(P=0.041)。应用针电极在76例(98.7%)患者中检测到AMR,与表面电极相比没有统计学差异(P=0.500),两者结果具有中等程度的一致性(Kappa=0.490,P<0.001)。结论表面电极对AMR的检测效能与针电极相似,并且具有无创的特点,可常规用于HFS的电生理评估。Objective To investigate the feasibility of using surface electromyography(SEMG)for the detection of abnormal muscle response(AMR)in patients with hemifacial spasm(HFS). Methods We retrospectively reviewed the clinical data of HFS patients who underwent microvascular decompression(MVD)in our hospital between June 2019 and December 2020. Patients who received both surface electrode(preoperative) and needle electrode(intraoperative)detection of AMR were included. SEMG recorded from two stimulation-recording sites,namely,zygomatic-mentalis and mandibular marginal-orbicularis oculi, was selected for analyzing the characteristics of AMR. The positive rates of AMR detected by these two kinds of electrodes were comprehensively compared. Results Totally 77 patients were included in this study. When detected with surface electrodes,the positive rate,latency and amplitude of AMR recorded at zygomaticmentalis oculi were 90. 9%(70/77),(10. 87±1. 86)ms and(202. 8±47. 4)μV, and at mandibular marginal-orbicularis oculi were 92. 2%(71/77),(10. 41±1. 83)ms and(211. 1±54. 1)μV, respectively. AMR was detected in 74 patients(96. 1%)with surface electrodes. There was no significant difference in positive rate, latency and amplitude of AMR between these two stimulation-recording methods. When detected with needle electrodes, the positive rate of AMR recorded at zygomatic-mentalis oculi was 98. 7%(76/77), which was significantly higher than the rate 89. 6%(69/77)recorded at mandibular marginal-orbicularis oculi(P=0. 016). The latency and amplitude of AMR recorded at zygomaticmentalis were(10. 63±1. 39)ms and(83. 5±27. 2)μV,and at mandibular marginal-orbicularis oculi were(10. 31±1. 18)ms and(58. 6±21. 4)μV. There was no significant difference in latency between the two stimulation-recording methods, but the amplitude recorded at mandibular marginal-orbicularis oculi was significantly lower(P=0. 041). AMR was detected in 76 patients(98. 7%)with needle electrodes. There was no significant difference in the detection rate of A

关 键 词：面肌痉挛 异常肌反应(AMR) 神经传导 表面电极 针电极 

分 类 号：R741.044[医药卫生—神经病学与精神病学]