慢性炎性脱髓鞘性多发性神经病与手外科疾病在肌电图中的相关性及鉴别分析  

Correlation and Differential Analysis between Chronic Inflammatory Demyelinating Polyneuropathy and Hand Surgical Diseases in Electromyography

作　　者：安倩男 黄霄云 李薇娜[3] AN Qiannan;HUANG Xiaoyun;LI Weina(Electromyogram Room,Central Hospital Affiliated to Shenyang Medical College,Shenyang,Liaoning,110024,China)

机构地区：[1]沈阳医学院附属中心医院肌电图室,辽宁沈阳110024 [2]复旦大学附属华山医院手外科,上海200040 [3]重庆医科大学附属巴南医院神经内科,重庆401320

出　　处：《实用手外科杂志》2025年第1期65-67,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨慢性炎性脱髓鞘性多发性神经病(Chronic inflammatory demyelinating polyneuropa-thy,CIDP)疾病与手外科疾病在肌电图中的表现及鉴别要点。方法回顾性分析经临床确诊的CIDP患者60例(CIDP组)以及手外科常见疾病(腕管综合征、肘管综合征等)患者60例(手外科疾病组)的肌电图资料,对比两组在运动神经传导、感觉神经传导及针极肌电图等方面的表现。结果CIDP组在运动神经传导上常表现为广泛的传导速度减慢(低于正常下限70%)及传导阻滞,感觉神经传导中SNAP波幅降低或消失、传导速度减慢,针极肌电图可见自发电位、MUP时限增宽等多种异常且呈广泛性分布。手外科疾病组肌电图异常多局限于单条神经支配区域,如腕管综合征主要累及正中神经,肘管综合征主要影响尺神经,在相应神经的感觉和运动传导以及针极肌电图上呈现特征性改变。结论CIDP疾病与手外科疾病在肌电图表现上存在显著差异,两者的肌电图对鉴别诊断十分必要,有助于准确诊断与治疗方案的合理制定。Objective To explore the manifestations and differential key points of Chronic Inflammatory Demyelinating Polyneuropathy(CIDP)and hand surgical diseases in electromyography.Methods The electromyogram data of 60 patients with clinically diagnosed CIDP(CIDP group)and 60 patients with common hand surgical diseases(such as carpal tunnel syndrome,cubital tunnel syndrome,etc.)(hand surgical disease group)were retrospectively analyzed.The manifestations of the two groups in motor nerve conduction,sensory nerve conduction,and needle electromyography were compared.Results In the CIDP group,motor nerve conduction often presented with widespread slow conduction velocity(less than 70%of the normal lower limit)and conduction block.In sensory nerve conduction,the amplitude of sensory nerve action potential(SNAP)decreased or disappeared,and the conduction velocity slowed down.In needle electromyography,multiple abnormalities such as spontaneous potentials and widened motor unit potential(MUP)duration were observed,and they were widely distributed.In the hand surgical disease group,the electromyogram abnormalities were mostly limited to the innervation area of a single nerve.For example,carpal tunnel syndrome mainly involved the median nerve,and cubital tunnel syndrome mainly affected the ulnar nerve,showing characteristic changes in the sensory and motor conduction of the corresponding nerves and needle electromyography.Conclusion There are significant differences in electromyogram manifestations between CIDP and hand surgical diseases.The electromyograms of the two are essential for differential diagnosis,which is helpful for accurate diagnosis and the rational formulation of treatment plans.

关 键 词：慢性炎性脱髓鞘性多发性神经病 手外科疾病 肌电图 鉴别诊断 

分 类 号：R74[医药卫生—神经病学与精神病学]