肌萎缩侧索硬化患者的腹直肌肌电图检测

An electromyographic detection of rectus abdominis muscles in patients with amyotrophic lateral sclerosis

目的：探讨腹直肌针极肌电图（EMG）在肌萎缩侧索硬化（ALS）中的诊断价值。方法：对ALS组58例患者进行常规EMG检测，包括上、下肢肌肉、胸锁乳突肌、下胸段脊旁肌及腹直肌，测定自发电位、募集相、运动单位电位（MUP）时限、波幅及多相波，对健康对照组36例健康志愿者进行腹直肌EMG的检测，比较ALS组与对照组腹直肌EMG的差异，以及ALS组中腹直肌EMG与下胸段脊旁肌EMG的差异。结果：健康对照组腹直肌EMG的MUP参数分别为波幅（389±35．7）μV，时限（9．78±1．23）ms，多相波（16．2±5．2）％；ALS组腹直肌EMG的MUP参数分别为波幅（675±135）μV，时限（12．78±1．03）ms，多相波（36．2±7．2）％，ALS组腹直肌EMG各参数与健康对照组比较差异有统计学意义；ALS组腹直肌EMG神经原性改变（43／58，74％）与下胸段脊旁肌EMG（39／58，67％）比较差异无统计学意义。结论：腹直肌EMG各参数均能可靠、稳定地测出，可作为诊断ALS患者胸段下运动神经元病变的辅助手段。

Objective：To assess the value of the electromyography（EMG）of rectus abdominis muscles in patients with amyotrophic lateral sclerosis（ALS）. Methods： Standard EMG was recorded from upper and lower limb muscles, at sternocleidomastoid muscles, lower thoracic paraspinal muscles and rectus abdominis muscles in 58 patients with ALS. Parameters study included spontaneous activity; duration amplitude and percentage of polyphasie waves of MUP, pattern of recruitment. EMGs of rectus abdominis muscles were also recorded from 36 healthy controls. EMG parameters of rectus abdominis muscles were compared between patients with ALS and the controls. The differences of EMG changes between rectus abdominis muscles and lower thoracic paraspinal muscle were analyzed in ALS patients. Results： The normative values of amplitude,duration and polyphasic wave of MUP of rectus abdominis muscles in the controls were（389 ± 35.7 ）μV, （ 9.78 ± 1.23）ms, （16.25.2） %, respectively significantly different from those in ALS patients which were（675±35）μV,（12.78±1.03）ms, （36.2±7.2）%,respectively. There was no difference of EMG changes between rectus abdominis muscle（43 / 58, 74%） and lower thoracic paraspinal muscle（39 / 58,67%）in patients with ALS. Conclusion： Neurogenic changes of EMG in rectus abdominis muscles might be regarded as an evidence of the lesion in lower motor neuron involved in thoracic region and is helpful for the diagnosis of ALS.