肌电图在鉴别诊断脂质沉积性肌病和炎性肌病中的价值

The value of EMG in the differentiation of lipid storage myopathy from inflammatory myopathy

通过对不同原因两组肌病的临床及肌电图（ＥＭＧ）等研究，对其诊断和鉴别诊断提供帮助。方法１８例脂质沉积性肌病（简称第１组）和１８例炎性肌病（简称第２组）均行常规同心圆针电极ＥＭＧ检查；肌肉病理检查包括各种组织化学染色的光镜检查和常规超薄切片的电镜检查。结果第１组ＥＭＧ自发电位为１４％明显低于第２组的５５％（Ｐ＜０．００１）；其他各项ＥＭＧ参数两组之间差异无显著意义；有肌痛者，自发电位检出率在第１组占２２％，第２组占７０％，明显高于第１组（Ｐ＜０．００１）。结论通过两组肌病的对比，如临床上有明显的肌肉无力和疼痛、血肌酶谱升高、在疼痛部位未找到或偶见自发电位者，应考虑脂质沉积性肌病的可能。

Objective Clinical and electromyographic were studied in patients with myopathies for the diagnosis and differential diagnosis of them. Methods Routine concentric needle electrode electromyography (EMG) was performed in 18 patients with lipid storage myopathy (group I) and 18 with polymyositis and dermatomyositis (group Ⅱ). Muscle biopsy specimen were stained or processed histochemically and viewed in the light microscopy and electron microscopy. Results There was a remarkable decreased proportion of spontaneous activity (SA) in group I (14%) than that in group Ⅱ (55%) ( P <0.01) and there were no significant differences in the other EMG parameters. In the muscle sites with myalgia, SA incidence was 22% in group I and 70% in group Ⅱ ( P <0.001). Conclusion It was suggested in the comparative study of the two groups of patients that the lipid storage myopathy might be diagnosed when the patients had muscle weakness, myalgia without or with occasional SA and increased creatine phosphokinase (CPK), lactate dehydrogenase (LDH) and hydrokybutyrate dehydrogenase (HBD).