颏舌肌自发电位在肌萎缩侧索硬化诊断及病情严重程度评估中的应用

Application of Genioglossal Muscle Spontaneous Potential in Diagnosis and Severity Evaluation of Amyotrophic Lateral Sclerosi

目的探讨颏舌肌自发电位检测在肌萎缩侧索硬化(ALS)诊断及病情严重程度评估中的应用价值。方法收集2015年1月至2021年9月均行颏舌肌肌电图检测的88例ALS患者的病情严重程度资料。回顾性分析临床资料评价颏舌肌自发电位与ALS患者病情严重程度的相关性。根据是否合并球部症状和自发电位差异分为球部症状组40例和无球部症状组48例。结果球部症状组颏舌肌自发电位阳性率31/40例(77.50%)显著高于无球部症状组24/48例(50.00%),差异有统计学意义(P<0.05);球部症状组ALS-FRS总分和ALS-FRS延髓评分[(8.19±1.26)分和(28.19±3.63)分]较无球部症状组[(11.23±2.30)分和(32.58±4.46)分]显著降低(P<0.05)。两组间纤颤电位和正锐波半定量水平比较,差异无统计学意义(P>0.05)。Spearman相关性分析显示,纤颤电位与ALS-FRS总分间呈负相关(r=-0.28,P=0.03);正锐波与ALS-FRS总分无相关性(r=-0.09,P=0.64)。结论球部亚临床ALS患者颏舌肌自发电位阳性率较高,且该电位与ALS病情严重程度相关。

Aim To investigate the application of genioglossal muscle spontaneous potential in diagnosis and severity evaluation of amyotrophic lateral sclerosi(ALS).Methods Clinical data of 88 patients with ALS,from January 2015 to December 2020 in our hospital,was collected and retrospectively studied.All patients underwent genioglossus electromyography and were divided into bulb symptoms group(40 cases)and no bulb symptoms group(48 cases)according to the combination of symptoms and spontaneous potential.Results The positive rate of genioglossus spontaneous potential in the bulbar symptom group[77.50%(31/40)]was statistically significantly higher than that in the non-bulbar symptom group[50.00%(24/48 cases)](P<0.05).The total ALS-FRS score[(8.19±1.26)points]and the medulla oblongata score[(28.19±3.63)points]in the bulbar symptom group were significantly lower than those in the non-bulbar symptom group(P<0.05),which were(11.23±2.30)points,(32.58±4.46)points separately.There was no significant difference in half quantitative level between fibrillation potential and positive sharp wave(P>0.05).Spearman correlation analysis showed that fibrillation potential was negatively correlated with the total score of ALS-FRS(r=-0.28,P=0.03),and there was no correlation between positive sharp wave and the total score of ALS-FRS(r=-0.09,P=0.64).Conclusion The positive rate of spontaneous potential in the genioglossal muscle of subclinical ALS patients was higher,and the potential was related to the disease severity.