基于表面肌电信号特征的肝豆状核变性下肢肌张力障碍临床评估研究  

Clinical assessment of lower limb dystonia in hepatolenticular degeneration based on surface electromyography signal features

作　　者：许芸 汪世靖 赵蕊 朱凌 夏昆 韩永升 XU Yun;WANG Shijing;ZHAO Rui(Graduate School of Anhui University of Chinese Medicine,Hefei 230000,China)

机构地区：[1]安徽中医药大学研究生院,安徽合肥230000 [2]安徽中医药大学神经病学研究所附属医院四病区,安徽合肥230000 [3]皖南医学院,安徽芜湖241000

出　　处：《中风与神经疾病杂志》2025年第1期13-18,共6页Journal of Apoplexy and Nervous Diseases

基　　金：安徽省临床医学研究转化专项(202204295107020047);安徽省中医药传承创新科研项目(2022CCZD05);新安医学与中医药现代化研究所“揭榜挂帅”项目(2023CXMMTCM002);安徽中医药大学校级科研项目(2021sfylc33)。

摘　　要：目的 分析肝豆状核变性,也称Wilson病(WD)下肢肌张力障碍患者表面肌电信号的特征,探讨表面肌电图(sEMG)作为WD下肢肌张力障碍评估工具的可行性。方法 纳入36例WD下肢肌张力障碍患者(观察组)以及20例WD无下肢肌张力障碍患者(对照组),同时选取20例正常人作为健康组。sEMG采集受试者行走状态下胫骨前肌、腓肠肌、股直肌的AEMG、MF、MPF、iEMG值,Spearman秩相关分析双下肢股直肌iEMG值与日常生活能力量表(ADL)、肝豆状核变性神经系统部分量表(UWDRS-Ⅰ)、肌张力障碍量表(BFMDRS)、改良Ashworth量表以及10 m步行时间之间的相关性,并计算比较观察组与健康组两侧同名肌肉的对称指数(SI),最后将观察组的SI值同样与量表评分、步行时间进行相关性分析。结果 3组受试者的iEMG值以及股直肌的所有肌电值之间均有显著差异(P<0.05),观察组股直肌iEMG值与ADL量表之间呈负相关,与肌张力障碍相关量表以及10 m步行时间呈正相关,说明股直肌iEMG值可反映WD下肢肌张力障碍的严重程度。同时,观察组与健康组双侧肌肉的SI值具有显著差异(P<0.05),观察组肌肉的SI值同样与ADL量表之间呈负相关,与其他变量呈正相关,表示WD下肢肌张力障碍具有不对称性,不对称程度与其肌张力障碍程度存在正相关。结论 sEMG在评估WD患者下肢肌张力障碍中具有应用价值,作为WD下肢肌张力障碍的评估工具使用具有可行性。Objective To investigate the features of surface electromyography(sEMG)signals in patients with lower limb dystonia and hepatolenticular degeneration,also known as Wilson disease(WD),as well as the feasibility of sEMG as an assessment tool for lower limb dystonia in WD.Methods A total of 36 WD patients with lower limb dystonia(observation group)and 20 WD patients without lower limb dystonia(control group)were enrolled,and 20 normal subjects were enrolled as healthy group.The sEMG technique was used to measure the AEMG,MF,MPF,and iEMG values of the anterior tibial muscle,the gastrocnemius muscle,and the rectus femoris muscle in the walking state,and a Spearman’s rank correlation analysis was used to investigate the correlation of the iEMG value of the rectus femoris muscle in both lower limbs with Activities of Daily Living(ADL),the neurological subscale of Unified Wilson’s Disease Rating Scale(UWDRS-I),the Burke-Fahn-Marsden Dystonia Rating Scale(BFMDRS),the Modified Ashworth Scale,and 10-meter walking time.The observation group and the healthy group were compared in terms of the symmetry index(SI)of the same-named muscles on both sides,and the correlation of SI value with scale scores and walking time was analyzed for the observation group.Results There were significant differences in iEMG values and all electromyography values of the rectus femoris muscle between the three groups(P<0.05).In the observation group,the iEMG value of the rectus femoris muscle was negatively correlated with the ADL scale and was positively correlated with dystonia-related scales and 10-meter walking time,suggesting that the iEMG value of the rectus femoris muscle could reflect the severity of lower limb dystonia in WD.Meanwhile,there were significant differences in the SI values of bilateral muscles between the observation group and the healthy group(P<0.05),and for the observation group,the SI values of the muscles were negatively correlated with the ADL scale and were positively correlated with other variables,suggesting that

关 键 词：肝豆状核变性 下肢 肌张力障碍 表面肌电图 

分 类 号：R742.4[医药卫生—神经病学与精神病学]