159例运动神经元病患者的临床和肌电图特征分析  

Analysis of clinical and electromyographic characteristics of 159 patients with motor neuron disease

作　　者：曹春艳[1] 刘祖翔 田璐 曹可馨 富奇志[4] 彭慧芳 CAO Chunyan;LIU Zuxiang;TIAN Lu(Department of Neurology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang(471000),Henan,China)

机构地区：[1]河南科技大学第一附属医院神经内科,河南洛阳471000 [2]唐河县人民医院电生理科 [3]齐齐哈尔医学院 [4]河南科技大学第一附属医院重症医学内科 [5]河南科技大学第一附属医院内分泌科

出　　处：《癫痫与神经电生理学杂志》2022年第2期83-90,共8页Journal of Epileptology and Electroneurophysiology(China)

基　　金：河南省中国科学院科技成果转移转化项目(2018105)。

摘　　要：目的分析运动神经元病(MND)患者的临床特征以及神经肌电图的特征性表现。方法选择2015年3月至2021年7月河南科技大学第一附属医院神经内科收治的159例MND患者,收集其临床和神经电生理资料。结果MND患者运动神经受损而感觉神经传导正常(年龄>50岁和糖尿病患者除外)。159例患者针极肌电图发现颅、颈、胸、腰骶段的肌肉广泛存在神经原性损害,34.3%的肌肉具有临床无症状性的下运动神经元损害表现,其中束颤比率高的肌肉是肱二头肌为40.4%、胫前肌为32.1%及第一骨间肌为30.8%,F波潜伏时延长、出现率低和巨大F波异常率为35.2%,重复电刺激(RNS)异常率为18.2%。结论神经电生理检查为MND的早期诊断和鉴别诊断提供客观的电生理学依据,并且可动态观察疾病的病程及进展。Objective To analyze the clinical features of motor neuron disease(MND)and the manifestations of neuroelectromyograph.Methods A total of 159 MND patients admitted to the Department of Neurology,the First Affiliated Hospital of Henan University of Science and Technology from March 2015 to July 2021 were enrolled.Clinical and neurophysiological data of these patients were collected.Results This study showed that motor nerves were damaged but sensory nerve conduction was normal in MND patients(excluded age>50 years and diabetic patients).The needle EMG images of 159 MND patients found extensive neurogenic damage in the muscles of cranial,cervical,thoracic and lumbosacral segments,34.3%of muscles had lower motor neuron injury without clinical symptoms.Among them,the muscles with high incidence rate of fasciculation was biceps brachii(40.4%),tibialis anterior muscle(32.1%)and first interosseous muscle(30.8%).The abnormal rate of F wave latency was prolonged,and the incidence rate of F wave was low.The incidence rate of giant F wave appearance was 35.2%,and the abnormal rate of repetitive nerve stimulation(RNS)was 18.2%.Conclusion Neuroelectrophysiological examination provides objective electrophysiological basis for the early diagnosis and differential diagnosis of MND,and may dynamically observe MND course and progression.

关 键 词：运动神经元病(MND) 神经肌电图 F波 重复电刺激(RNS) 束颤 针极肌电图 

分 类 号：R744.8[医药卫生—神经病学与精神病学] R741.044[医药卫生—临床医学]