基于肛门括约肌临检的多系统萎缩病症分析  

Clinical Characteristics and External Anal Sphincter Electromyogram for Multiple System Atrophy

作　　者：孟萌 徐晓彤 万志荣[2] 李秀花[1] 徐长波[1] 靳冬梅 MENG Meng;XU Xiao-tong;WAN Zhi-rong;LI Xiu-hua;XU Chang-bo;JIN Dong-mei(Department of Neurology,731 Hospital of China Aerospace Science and Industry Group,Beijing 100074,China;Department of Neurology,Aerospace Central Hospital,Beijing 100049,China)

机构地区：[1]中国航天科工集团七三一医院神经内科,北京100074 [2]航天中心医院神经内科,北京100049

出　　处：《科学技术与工程》2024年第25期10726-10730,共5页Science Technology and Engineering

基　　金：航天中心医院科研基金(YN202102)。

摘　　要：分析了多系统萎缩患者临床特点和肛门括约肌肌电图特征,探讨了肛门括约肌肌电图对多系统萎缩早期临床诊断的价值。回顾性分析多系统萎缩患者26例,采集患者一般资料、日常生活活动能力评分、肛门括约肌肌电图结果。以是否出现卫星电位、是否存在尿便障碍、是否有体位性低血压分别进行分组比较,比较组间患者的年龄、病程、日常生活活动能力评分、肛门括约肌肌电图结果。同时分析病程、肛门括约肌肌电图运动单位动作电位平均时限、日常生活活动能力评分和病程的相关性。26例多系统萎缩患者中最常见症状依次为尿便障碍、走路不稳及睡眠障碍;最常见体征依次为肌张力障碍、体位性低血压及共济失调;26例患者运动单位动作电位平均时限为11.6 ms(范围为10.1~14.5 ms),平均波幅为876.5μV(范围为740.8~1135.8μV),多相波百分比为27.4%(范围为13.3%~53.6%);卫星电位组比无卫星电位组运动单位动作电位平均时限长、多相波百分比高、日常生活活动能力评分低(P<0.05);体位性低血压组比无体位性低血压组日常生活活动能力评分低(P<0.05);多系统萎缩患者的病程与日常生活活动能力评分呈显著负相关(r=-0.695,P=0.000),病程与运动单位动作电位平均时限无明显相关性,日常生活活动能力评分与运动单位动作电位平均时限无明显相关性。多系统萎缩患者病程越长,病情越重,出现卫星电位或出现体位性低血压病情更重,肛门括约肌肌电图有利于无尿便障碍多系统萎缩患者早期诊断。The clinical features and electromyography features of anal sphincter in patients with multiple system atrophy were analyzed,and the value of electromyography of anal sphincter in early diagnosis of multiple system atrophy was discussed.A retrospective analysis was conducted on 26 patients with complete information who were hospitalized for multiple system atrophy from January 2019 to July 2022 at the Aerospace Center Hospital.The patients general information,activities of daily living score,and external anal sphincter electromyography results were collected.The patients were grouped based on whether there were satellite potential,urinary and bowel disorders,or orthostatic hypotension,and the age,duration of disease,activities of daily living score,and external anal sphincter electromyography results were compared between the groups.The correlation between the motor unit potentials average duration of external anal sphincter electromyography,disease duration,and activities of daily living score were analyzed.The most common symptoms in 26 multiple system atrophy patients are urinary and bowel disorders,gait disturbance,and sleep disorders,while the most common signs are muscle tension disorders,orthostatic hypotension,and ataxia.The mean duration of motor unit action potential in 26 patients is 11.6 ms(range 10.1 ms to 14.5 ms),the mean amplitude is 876.5μV(range 740.8μV to 1135.8μV),and the percentage of multiphase wave is 27.4%(range 13.3%to 53.6%).The group with satellite potential has a longer average duration,a higher percentage of multiphasic waves,and lower activities of daily living scores(P<0.05).The group with orthostatic hypotension has lower activities of daily living scores(P<0.05).The disease duration of multiple system atrophy patients is significantly negatively correlated with activities of daily living scores(r=-0.695,P=0.000),while there is no significant correlation between disease duration and the average duration of motor unit potentials,or between activities of daily living score and the

关 键 词：多系统萎缩 肛门括约肌肌电图 尿便障碍 体位性性低血压 日常生活活动能力评分 

分 类 号：R741.041[医药卫生—神经病学与精神病学]