模式匹配肌电图对神经原性损害的诊断作用

DIAGNOSTIC YIELD OF MOTOR UNIT POTENTIAL PARAMETERS OF TEMPLATE MATCHING ELECTROMYOGRAPHY IN NEUROGENIC LESIONS

目的 :证实模式匹配肌电图的运动单位电位 (MUP)不同参数的临床神经生理意义以及不同运动单位募集对临床诊断的影响。方法 :胫前肌、拇短展肌、股四头肌正常组 52 56个MUP ,神经病组 1 91 3个MUP通过模式匹配方法记录。对轻度、中度用力肌肉收缩记录的MUP分别进行判别分析和显著性检验。结果 :单一参数中 ,面积的诊断作用最敏感 ,可判别 73 2 %～ 79 6%的神经病变组MUP。时限的诊断敏感性低于面积和波幅。大小指数 (SI)的诊断作用与面积相似。在胫前肌和股四头肌 ,轻度比中度用力收缩MUP各项参数的诊断作用更加敏感。结论 :模式匹配肌电图MUP面积、SI、波幅、时限为重要临床诊断参数 ,四肢大肌群轻度用力收缩所募集的MUP各项参数诊断作用更为敏感。

Objective:To determine the role of motor unit potential(MUP) parameters of template matching electromyography in diagnosis of neurogenic lesions.Methods:Of 7 169 MUP,5 256 from normal group and 1 913 from neurogenic group were recorded in the muscles of tibialis anterior,vastus medialis and abductor pollicis brevis.The MUP registered under slight and moderate muscle contractions were analyzed with discriminate and significance analysis.Results:As a single parameter,the area produced a better result in discriminating neurogenic MUP from control,with 73 2%-79 6% of MUP from neurogenic muscles being judged as abnormal and 14 7%-15 7% MUP from normal muscles being misclassified.In discriminating neurogenic MUP,the size index was as efficient as the area,but the duration was less sensitive than the area and amplitude.In the recruitment test of tibialis anterior and vastus medialis,all the parameters of the MUP from slight muscle contraction were more sensitive than those from moderate muscle contraction.Conclusion:In diagnosis of neurogenic MUP,the area, size index,amplitude, and duration appeared to be the most important parameters and the slight muscle contraction in the motor unit recruitment delivered a better diagnostic yield.