脊髓损伤后胫骨前肌运动单位数目测定的意义

The significance of estimation for motor unit number in the tibialis anterior muscle in spinal cord injury

目的:建立健康成人胫骨前肌运动单位的正常值并探讨其在脊髓损伤(spinalcordinjury,SCI)研究中的意义。方法:采用改良多点刺激技术对45例健康成人(20～59岁35例,≥60岁10例)和20例SCI患者(伤后1～6个月,亚急性期组10例;伤后1年以上,慢性期组10例)进行胫骨前肌运动单位数目测定,并随访观察SCI患者胫骨前肌运动单位数目的变化情况。结果:45例健康成人胫骨前肌运动单位数目为188±20个,不同年龄组、性别间无显著性差异(P>0.05)。SCI亚急性期组初测胫骨前肌运动单位数目平均为40±33个,随访1个月时为71±37个,随访3个月时为116±41个,三次检查间均有显著性差异(P<0.01);SCI慢性期组初测时胫骨前肌运动单位数目平均为173±29个,与正常值无明显差异,随访3个月时为177±34个,与初测时无明显变化(P>0.05)。结论:胫骨前肌运动单位数目在SCI后不同时间发生不同变化,测量其数目变化可能有助于对SCI的诊断、治疗和预后的定量评估。

Objective：To determine the normal number of motor units in the tibialis anterior （TA） muscle and investigate its significance in spinal cord injury （SCI）.Method：Forty-five health adults as a control（35 subjects at the age of 20-59 years and 10 subjects at the age above 60 years）,and twenty patients with SCI （10 subacute cases,l-6 months after injury;and 10 chronic cases,time of injury more tnan 1 year） were examined by adapted multiple point stimulation（AMPS） method to investigate the changes of motor unit number （MUN） following SCI.Result：In the control group,the mean MUN value of TA was 188＋20.There were no significant differences in the MUN values between the different age groups.In the subacute SCI group,the mean value was 40±33 at primary survey,71±37 at 1 month follow up and 116±41 at 3 months follow up（P〈 0.01,among 3 tests）.In the chronic SCI group,the MUN value was 173±29 at primary survey and 177±34 at 3 months follow up（P〉0.05,between 2 tests）,and there was no significant difference compared to those in the control group.Conclusion：Changes of the MUNE value from the TA muscle are different depending on the time after SCI.And measuring these changes will perhaps contribute to the quantitative evaluation of SCI diag- nosis, treatment and prognosis.