表面眼肌电信号检测及临床应用研究

Study of ocular surface electromyography signal analysis

目的利用表面眼肌电信号波、特征参数，为麻痹性眼肌疾病诊断、疗效观察提供客观数据。方法眼肌电信号检测水平肌肉时，将电极置于内眦、外眦和额部正中的皮肤，在弧形视野计上安装可交替闪烁的小红灯，引导眼球做水平扫视运动。测试垂直肌肉时，将电极置于眼眶上、下中央和额部正中的皮肤上，将视野弧转动至颞上鼻下25度和鼻上颞下25度，通过红灯交替闪烁记录垂直扫描运动。眼疾麻痹患者，检测方法同上。对140名正常受检者和30名眼肌麻痹患者进行表面眼肌电检测。结果正常受检者眼肌电信号规整，波形大致相似。男女之间、各年龄组之间波形无明显区别。眼肌麻痹患者，在其眼肌运动障碍的某一方向，引出的眼肌电信号有相似的波幅降低或消失，其降低程度与相应的眼外肌病变程度有关。正常受检者和眼肌麻痹患者表面眼肌电图型有明显不同。结论表面眼肌电信号检测具有无创安全的特点，易于被患者接受。表面眼肌电特征参数将针刺眼肌电图的定性分析转变为定量分析，有助于临床诊断和疗效观察。

Objective Test ocular surface electromyography signal waves and characteristic parameters to provide effective data for the diagnosis and treatment of ocular myopathy. Methods Surface electromyography signals tests were performed in 140 normal volunteers and 30 patients with ophthalmoplegia. Surface electrodes were attached to medial canthi, lateral canthi and the middle of frontal bone. Then some alternate flashing red lamps were installed on perimeter to reduce the movement of eyeball. The computer hardware, software, and A/D adapter （ 12 Bit ） were used. Sumpling frequency could be selected within 40 kHz, frequency of amplifier was 2 kHz, and input short circuit noise was less than 3 pN. Results For normal volunteers, the ocular surface electromyography signals were regular, and the electric waves were similar between different sex groups and age groups. While for patients with ophthalmoplegia, the wave amplitude of ocular surface electromyography signals were declined or disappeared in the dyscinesia direction. The wave amplitude was related with the degree of pathological process. The characteristic parameters of patients with ophthalmoplegia were higher than normal volunteers. Conclusion The figures of ocular surface electromyogram obtained from normal volunteers were obviously different with that from patients with ophthalmoplegia. This test can provide reliable quantized datas for the diagnosis and treatment of ocular myopathy.