功能性排便障碍患者经腰刺激运动诱发电位的研究

Translumbar motor-evoked potentials in diagnosis of functional defecation disorders

目的探讨经腰磁刺激运动诱发电位对功能性排便障碍（functional defecation disorders,FDD）的诊断价值。方法收集2010年3月至2011年9月本院住院或门诊的FDD患者80例（男性37例,女性43例）,年龄23~69（53.12±17.60）岁,病程（8.28±6.14）年;同期招募健康志愿者30例作为正常对照组（男性13例,女性17例）,年龄19~35（25.67±7.32）岁。通过磁刺激腰骶部,记录肛门外括约肌动作电位潜伏期和波幅变化,观察腰脊神经根到肛门外括约肌的运动神经传导功能。结果正常对照组检测波幅为400~1 100（725.63±178.23）μV,潜伏期为2.6~3.7（3.35±0.41）ms。FDD组和正常对照组左右侧MEP各参数比较差异均无统计学意义（P〉0.05）;与正常对照组比较,FDD组波潜伏期延长,波幅下降,差异有统计学意义（P〈0.05）。结论经腰磁刺激运动诱发电位对功能性排便障碍的诊断具有重要价值。

Objective To evaluate the diagnostic value of translumbar magnetic stimulation motor evoked potentials for functional defecation disorders（FDD）.Methods Eighty cases of FDD in-and out-patients in our department from March 2010 to September 2011 were enrolled in the study.Another 30healthy volunteers were recruited during the same period.The patients were 37 males and 43 females,with a mean age of 53.12±17.60（ranging from 23 to 69） and a mean course of 8.28±6.14 years.While the normal control group included 13 males and 17 females,with a mean age of 25.67±7.32（ranging from 19 to35）.Anorectal motor evoked potentials（MEP） was recorded after translumbar magnetic stimulation（TMS）over bilaterally lumbar nerve root to observe the motor nerve conduction in external anal sphincter.Results The amplitude of magnetic stimulation-lumbar motor evoked potentials（MS-LMEP） in the external anal sphincter was 725.63±178.23 μV（ranging from 400 to 1 100）,and the latency was 3.35±0.412 ms（ranging from 6 to 3.7） in normal control.The amplitude was decreased,and the latency was prolonged compared with those of normal control（P0.05）.But there was no significant difference in both sides between the 2 groups（P 0.05）.Conclusion Translumbar magnetic stimulation motor evoked potentials have a significant value in the diagnosis of FDD.