骨骼肌钝挫伤后愈合质量的肌电评价  

Evaluation of Skeletal Muscle Healing Following Contusion by Electromyography

作　　者：陈疾忤[1] 陈世益[1] 李云霞[1] 张鹏[1] 

机构地区：[1]复旦大学附属华山医院运动医学科,上海200040

出　　处：《中国运动医学杂志》2004年第1期21-26,共6页Chinese Journal of Sports Medicine

基　　金：国家自然科学基金 (30 170 4 4 6 );上海市医学"百人计划"(97BR0 17)资助项目

摘　　要：目的 :观察大鼠骨骼肌钝挫伤后 ,不同干预方法对骨骼肌修复过程中肌电信号的影响 ,研究肌电图在骨骼肌损伤愈合过程中的评价作用。方法 :10 8只雄性SD大鼠 ,利用自制的重物坠落打击装置造成右侧腓肠肌钝挫伤。随机分成 3组 ,即胰岛素样生长因子 - 1(IGF - 1)组、中药组和自然愈合组 ,分别于损伤局部注射IGF - 1、黄芪丹参注射液、不作处理。于伤后第 2、5、7、10、14、2 1、2 8、35、5 6天观察并比较双侧腓肠肌的肌电图变化 ,记录纤颤电位和正尖波等自发活动 ,分析复合肌肉动作电位 (CMAP)并测量其潜伏期和波幅 ,观察伤后CMAP的变化。结果 :(1)各组大鼠均于伤后第 2～ 5天出现纤颤电位和正尖波 ,约至第 7～ 10天达到高峰 ,然后逐渐减少。以IGF - 1组最早消失 ,中药组次之。 (2 )各组大鼠的伤侧肌电图CMAP中的潜伏期逐渐缩短 ,波幅逐渐增高。以IGF - 1组最快 ,中药组次之 ,自然愈合组最慢。 (3)伤后第 8周 ,IGF - 1组和中药组大鼠损伤侧CMAP波幅接近正常 ,自然愈合组则显著低于其它两组。结论 :(1)肌电图检测证实 ,IGF - 1和黄芪丹参注射液均具有促进骨骼肌损伤愈合的作用 ,但以IGF - 1的作用更明显。 (2 )损伤肌肉局部肌电信号的变化 。Objective To observe the effect of different interventions on muscle healing following contusion by electromyographical signal, and functionally to study the significance of electromyographical technique in evaluating the healing quality of skeletal muscle after injuries. Methods A standard contusion model was developed at the right gastrocnemius by specific device in 108 male rats. The animals were divided into three groups:group IGF-1,local injection by exogenous IGF-1 at injured site; group Chinese medicine treated with the injection of Huangqidanshen, and group natural healing for control. EMG signals of gastrocnemius, such as fibrillation potentials, positive sharp waves as well as the latency and wave-amplitude of compound muscle action potentials (CMAPs) were probed, recorded and compared at day 2、5、7、10、14、21、28、35 and 56 after injury respectively. Results (1) Fibrillation potentials and positive sharp waves were discovered at day 2 to 5 after contusion, and reached its peak by day 7 to 10, and then normalized gradually around the 35th day with muscle healing in group natural healing. Above abnormal signals disappeared much more early in group IGF-1, then that in group Chinese medicine. (2) The latency and wave-amplitude of CMAP shown a gradual recovery process with muscle healing. The recovery tendency was most rapid in group IGF-1, slower in group Chinese medicine, and latest in group natural healing. (3) The wave-amplitude of CMAP approached to normal in group IGF-1 by 8 weeks following contusion, a little bit later in group Chinese medicine groups, and lastly in group natural healing. Conclusions(1) Electromyographical study verified that IGF-1 and Huangqidanshen could improve healing and functional recovery following muscle injury. IGF-1 was a much more strong intervention for healing promotion. (2) EMG is an useful tool in evaluating the healing process and healing quality of skeletal muscle.

关 键 词：骨骼肌钝挫伤 愈合 肌电图 胰岛素样生长因子-1 中药 黄芪丹参注射液 

分 类 号：R87[医药卫生—运动医学]