36例手足口病合并急性弛缓性麻痹患儿的肌电图分析

An analysis of Electroneurophysiologiy in 36 patients with hand-foot-mouth disease with acute flaccid paralysis

目的：探讨神经电生理检查在手足口病（HFMD）合并急性迟缓性麻痹（AFP）患儿的特点及应用价值。方法：对36例手足口病合并急性迟缓性麻痹患儿进行运动神经传导速度（MCV）、感觉神经传导速度（SCV）、F波及肌电图（EMG）检查，共检测176条运动神经、88条感觉冲经、98条神经的F波及285块肌肉，并对结果进行分析。结果：运动神经传导异常率为52．8％，其中运动传导波幅下降占81％，未引出反应波者为15％，MCV减慢或潜伏期延长者为4％，感觉传导异常牢为6％，F波异常率为10％，EMG出现自发电位者为28．4％，出现高大运动单位电位（MUP）者为48．1％，募集相减少63.9％。结论：HFMD合并AFP患儿有神经原性损害，以轴突损害电生理改变为主，多累及近端神经，以运动神经受累为主。神经电生理检查对HFMD合并AFP患儿的诊断治疗及判断预后有重要价值。

Objective：To investigate the characteristics and application value of electroneurophysiology in 36 patients with hand-foot mouth disease （HFMD） complicated with acute flaccid paralysis （AFP）. Methods： To measure motor nerve conduction velocity （MCV）, sensory nerve conduction veloci ty （SCV）, F waves and electromyogram（EMG） in 36 patients with HFMD complicated with AFP （AFP）. The nerve conduction of 176 motor nerves and 88 sensorr nerves and 98 F waves and EMG of 285 muscles were measured, and the result was analysed. Results：The abnormality of motor nerve conduction was found in 52.8% of 176 nerves, among which compound muscle action potential（CMAP） amplitude declined by 81%, the cases without the response of CMAP in 15%, MCV slowed or CMAP latency lengthened in 4 %, SCV abnormality in 6%, F wave abnormality in 10 %, spontaneous potential of EMG in 28.4% ,tall MUP in 48. 1% and recruitment order declined by 63. 9%. Conclusion： The children with HFMD complicate with AFP indicate neurogenic lesion, most of which present neuraxon damage with electrophysiologic change, and proximal nerves are involved, most of which are motor nerves. It is of great value that electrophysiologic measurement is used for diagnosis, treatment and estimating prognosis in chidren with HFMD complicated with AFP.