慢性酒精中毒性肌病的电生理表现  

Electrophysiological characteristics of chronic alcoholic myopathy

作　　者：郑健[1] 刘勇[1] 肖道弘[1] 邹永琴[1] 

机构地区：[1]第三军医大学新桥医院神经内科,重庆400037

出　　处：《第三军医大学学报》2004年第8期724-726,共3页Journal of Third Military Medical University

摘　　要：目的　探讨慢性酒精中毒性肌病的电生理改变特点。方法　对 2 6例慢性酒精中毒性肌病、13例慢性酒精中毒性周围神经病、2 1例慢性酒精中毒性神经和肌肉混合损害患者 ,以及 2 0例正常受试者 ,检测肌电图、单纤维肌电图、肌纤维传导速度、周围神经传导速度和诱发电位。结果　肌病组患者 9例呈肌源性肌电图异常改变 ,周围神经病组患者 7例为神经源性改变 ,混合损害组患者中有 4例同时出现两种类型改变。与正常对照受试者比较 ,各组患者神经肌肉颤抖值均增大 (P <0 .0 5 ) ,纤维密度增加 (P <0 .0 5 ) ,周围神经病组患者的神经肌肉颤抖值和纤维密度改变尤为显著 (P <0 0 1)。肌病组患者肌纤维传导速度明显减慢 (P <0 .0 5 ) ,其余两组患者无显著变化 (P >0 .0 5 )。周围神经病和混合损害组患者中 ,感觉神经传导速度减慢 2 8例 ( 82 3 5 %)。结论　肌电图检查和神经传导速度测定可帮助鉴别酒精中毒性肌病和周围神经病 。Objective To investigate the electrophysiological characteristics of chronic alcoholic myopathy. Methods Muscle fiber conduction velocity, peripheral nerve conduction velocity, and induced potentials in 26 patients with chronic alcoholic myopathy, 13 patients with chronic alcoholic peripheral neuropathy, 21 patients with chronic alcoholic neuromuscular damage, and 20 normal subjects were detected by electromyography and single fiber electromyography. Results Electromyography revealed myogenic changes in 9 cases in the myopathy group, neurogenic changes in 7 cases in the peripheral neuropathy group, and both kind of changes in 4 cases in the neuromuscular damage group. Compared with the normal subjects, neuromuscular jitter and fiber density increased in all patients ( P <0.05), especially in the patients with neuropathy ( P <0.01). Muscle fiber conduction velocity was significantly slower in all patients with myopathy ( P <0.05), but no significant change was found in the other two groups ( P >0.05). Slowed sensory nerve conduction velocity was found in 28 patients (82.35%) with peripheral neuropathy or neuromuscular damage. Conclusion Electromyography and determination of nerve conduction velocity can be used to differentiate the alcoholic myopathy from peripheral neuropathy. The abnormal muscle fiber conduction velocity can be helpful for the confirmation of myopathy.

关 键 词：酒精中毒 骨骼肌 神经 肌电图 神经传导速度 诱发电位 

分 类 号：R595.6[医药卫生—内科学] R741.044[医药卫生—临床医学]