肌萎缩性侧索硬化症患者神经传导速度的研究

Study of nerve conduction velocity in patients with amyotrophic lateral sclerosis

目的:探讨肌萎缩性侧索硬化症(ALS)患者神经传导速度(NCV)的改变及其在诊断和鉴别诊断中的价值。方法:以106例确诊为ALS的患者和123例正常人为研究对象,应用Keypoint肌电图仪进行正中、尺、胫和腓总神经的NCV检查,记录和刺激电极均为表面电极。结果:ALS组正中神经感觉神经传导速度(SCV)和正中、尺、腓总神经运动神经传导速度(MCV)较正常对照组明显降低,除正中神经感觉神经潜伏期外,两组比较,差异均有显著性意义;正中、尺、胫神经复合肌肉动作电位波幅ALS组明显低于正常组,但多无神经传导阻滞。结论:ALS组的MCV和SCV较正常对照组明显减慢,但在诊断和鉴别诊断方面,临床表现及针极肌电图比NCV更有价值。

Objective： To analysis the finding of never conduction velocity（NCV） in patients with ALS and investigate the clinical significance of NCV. Methods： Keypoint was applied to estimate the NCV of median, ulnar, tibial, peroneal in 106patients with ALS and 123healthy volunteers, in which sunface electrodes was used for both stimulating and recording. Results ： SCV of median and MCV of median, ulnar,peroneal in patient group was a significant difference as compared with the normal subjects; A significant difference was noted in all latency except sensory fiber of median. A significant differencence of compound muscle action potential amplitude of medial, ulnar, tibial was noted in two groups. Conclusion ： NCV in patients with ALS could show abnormal slowing, so the valuation for differentiation of NCV is not so good as the clinical signs and the distribution of electromyographic abnormalities.