自动分解肌电图运动单位动作电位各参数的分析和临床意义

Clinical significance and analysis of parameters of motor unit action potential by automatic decomposition electromyography.

目的：探讨运动单位动作电位（ＭＵＡＰ）各参数评价神经肌肉疾病的临床意义。方法：采用肌电图仪，以常规同心圆针电极记录，对７１例健康成人和４３例神经肌肉疾病患者的肱二头肌或／和胫前肌进行自动分解肌电图（ＡＤＥＭＧ）检测，共收集ＭＵＡＰ８３５６个，测定ＭＵＡＰ的５个参数：波幅、时限、转折数、发放率、棘波间隔变异系数（ＣＩＶ）。结果：１５例肌源性疾病患者表现为每一记录部位的ＭＵＡＰ数目增加；肱二头肌ＭＵＡＰ的波幅、时限、转折数减低、发放率增加，ＣＩＶ无改变；胫前肌ＭＵＡＰ的各参数无显著性改变。２８例神经源性疾病患者表现为每一记录部位的ＭＵＡＰ数目减少；ＭＵＡＰ的波幅、转折数及ＣＩＶ增加，时限及发放率无显著性增加。结论：ＡＤＥＭＧ检测的ＭＵＡＰ各参数对于评价神经肌肉疾病有重要的临床意义。

Objectives:To investigate the clinical significance of motor unit action potential (MUAP) parameters on neuromuscular disorders.Methods:Automatic decomposition electromyography (ADEMG) was done by inserting a standard concentric electrode into the mid portion of musculi biceps brachii (BB) or/and tibialis anterior (TA) in 43 patients with neuromuscular diseases and 71 healthy volunteers as control. The amplitude, duration, turns, firing rate and coefficient of interspike interval variability (CIV) were determined.Results:The number of MUAPs of each insertion was increased in 15 cases with myogenic disease. The amplitude, duration and turns were decreased, the firing rate increased and CIV unchanged detected on BB. However, no significant change was noted on TA. The number of MUAPs of each insertion was decreased in 28 cases with neurogenic disease. The amplitude, turns, and CIV were increased, and the duration and firing rate had no significant change.Conclusions:MUAP parameters by ADEMG might have certain important diagnostic value in neuromuscular disease.