中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2013年
1期
23-25
,共3页
肌萎缩侧索硬化%臂丛神经病%肌电描记术
肌萎縮側索硬化%臂叢神經病%肌電描記術
기위축측색경화%비총신경병%기전묘기술
Amyotrophic lateral sclerosis%Brachial plexus neuropathy%Electromyography
目的 探讨连枷臂综合征(FAS)的临床和神经电生理特点.方法 回顾分析2006年7月至2012年7月北京大学第三医院FAS患者、上肢起病的经典肌萎缩侧索硬化(ALS)患者、上臂丛神经病患者,对其临床表现和神经电生理特点进行分析、比较.神经电生理研究主要包括四肢神经传导和延髓、颈、胸、腰骶4区肌肉的肌电图检测.结果 共入组138例患者,其中FAS组56例,ALS组60例,上臂丛神经病22例.FAS患者中男∶女=5∶1,主要表现为双上肢近端肌无力、肌萎缩；上肢运动神经复合肌肉动作电位(CMAP)波幅下降,各区域肌肉肌电图不同程度的神经源性损害,其三角肌和肱二头肌运动单位动作电位(MUAP)波幅高于ALS组[(1531 ±76) μV比(898±57)μV；(1433±57) μV比(872 ±75) μV](F=13.25,6.33,均P＜0.05)；其第一骨间肌、三角肌和肱二头肌肌电图MUAP波幅高于臂丛神经病组[(1263±24) μV比(507±42) μV; (1531±76) μV比(564±27) μV; (1433±57) μV比(593±36) μV)](F=12.32,16.71,8.35,均P＜0.05).结论 连枷臂综合征患者男性较多见,主要累及双上肢近端,不同区域肌电图呈程度不同的神经源性损害,上肢运动神经CMAP波幅明显下降.
目的 探討連枷臂綜閤徵(FAS)的臨床和神經電生理特點.方法 迴顧分析2006年7月至2012年7月北京大學第三醫院FAS患者、上肢起病的經典肌萎縮側索硬化(ALS)患者、上臂叢神經病患者,對其臨床錶現和神經電生理特點進行分析、比較.神經電生理研究主要包括四肢神經傳導和延髓、頸、胸、腰骶4區肌肉的肌電圖檢測.結果 共入組138例患者,其中FAS組56例,ALS組60例,上臂叢神經病22例.FAS患者中男∶女=5∶1,主要錶現為雙上肢近耑肌無力、肌萎縮；上肢運動神經複閤肌肉動作電位(CMAP)波幅下降,各區域肌肉肌電圖不同程度的神經源性損害,其三角肌和肱二頭肌運動單位動作電位(MUAP)波幅高于ALS組[(1531 ±76) μV比(898±57)μV；(1433±57) μV比(872 ±75) μV](F=13.25,6.33,均P＜0.05)；其第一骨間肌、三角肌和肱二頭肌肌電圖MUAP波幅高于臂叢神經病組[(1263±24) μV比(507±42) μV; (1531±76) μV比(564±27) μV; (1433±57) μV比(593±36) μV)](F=12.32,16.71,8.35,均P＜0.05).結論 連枷臂綜閤徵患者男性較多見,主要纍及雙上肢近耑,不同區域肌電圖呈程度不同的神經源性損害,上肢運動神經CMAP波幅明顯下降.
목적 탐토련가비종합정(FAS)적림상화신경전생리특점.방법 회고분석2006년7월지2012년7월북경대학제삼의원FAS환자、상지기병적경전기위축측색경화(ALS)환자、상비총신경병환자,대기림상표현화신경전생리특점진행분석、비교.신경전생리연구주요포괄사지신경전도화연수、경、흉、요저4구기육적기전도검측.결과 공입조138례환자,기중FAS조56례,ALS조60례,상비총신경병22례.FAS환자중남∶녀=5∶1,주요표현위쌍상지근단기무력、기위축；상지운동신경복합기육동작전위(CMAP)파폭하강,각구역기육기전도불동정도적신경원성손해,기삼각기화굉이두기운동단위동작전위(MUAP)파폭고우ALS조[(1531 ±76) μV비(898±57)μV；(1433±57) μV비(872 ±75) μV](F=13.25,6.33,균P＜0.05)；기제일골간기、삼각기화굉이두기기전도MUAP파폭고우비총신경병조[(1263±24) μV비(507±42) μV; (1531±76) μV비(564±27) μV; (1433±57) μV비(593±36) μV)](F=12.32,16.71,8.35,균P＜0.05).결론 련가비종합정환자남성교다견,주요루급쌍상지근단,불동구역기전도정정도불동적신경원성손해,상지운동신경CMAP파폭명현하강.
Objective To explore the clinical and neuroelectrophysiological characteristics of flail arm syndrome (FAS).Methods The clinical and neuroelectrophysiological characteristics were analyzed retrospectively from July 1,2006 to July 1,2012 in FAS patients (n =56),those with upper limb onset amyotrophic lateral sclerosis (ALS) (n =60) and those with upper brachial plexus neuropathy (n =22)from our hospital.Nerve conduction study of musculocutaneous,axillary,median,ulnar,radial,tibial,peroneal and sural nerves and electromyogram (EMG) of bulbar,cervical,thoracic and lumbosacral regions were conducted.Results In FAS patients,the ratio of male-to-female was 5:1 and they were characterized by symmetric,proximal wasting and weakness of upper extremities,the involved muscles demonstrated neurogenic damage on EMG and the amplitude of compound muscle action potential (CMAP) of arms decreased.Compared with ALS patients,the amplitude of motor unit action potential (MUAP) of deltoid muscle and biceps muscle was higher in FAS patients ((1531 ±76) vs (898 ±57) μV; (1433 ±57) vs (872 ± 75) μV) (F =13.25,6.33 ; P ＜ 0.05).Compared with upper brachial plexus neuropathy patients,the amplitude of MUAP of first dorsal interosseous,deltoid and biceps muscles was higher in FAS patients ((1263±24) vs(507 ±42)μV; (1531 ±76) vs (564 ±27) μV; (1433 ±57) vs (593 ±36) μV) (F=12.32,16.71,8.35; P＜0.05).Conclusion The clinical manifestations of FAS are symmetric,proximal wasting and weakness of arms.And the involved muscles show denervation on EMG and the amplitudes of CMAPs decrease in motor nerves of upper extremities.
