肌电图在强直性肌营养不良中的诊断价值

The value of electromyography in diagnosis of myotonic dystrophy

目的探讨肌电图检查在诊断强直性肌营养不良中的价值。方法对26例强直性肌营养不良患者(肌强直组)进行针极肌电图和神经传导检测。检测25例非强直性神经肌肉疾病(对照组)有无肌强直放电。结果肌强直组肌电图主要特点呈典型肌强直放电,肌源性损害和正常的神经传导;肌强直放电拇短展肌的阳性率为87.5%,伸指总肌阳性率为77.8%,胫前肌的阳性率为57.1%,股四头肌和三角肌的阳性率为45.5%。对照组无肌强直放电。结论肌电图出现肌强直放电及肌源性损害是强直性肌营养不良区别于其他神经肌肉疾病的主要依据。肌强直放电主要出现在手部的小肌肉,但即使在肌强直放电出现率最高的拇短展肌其阳性率亦达不到100%。

Objective To explore the value of electrophysiology in diagnosis of myotonic dystrophy. Methods Electromyogra- phy（EMG） and nerve conduction were detected in 26 myotonic dystrophy patients（myotonia group）. Myotonic discharges were de- tected in 25 patients with non-tonic neuromuscular disease（control group）. Results The main features of EMG in myotonia group were myotonie discharges, myogenic damage, and normal nerve conduction. There was no myotonic discharges in control group. The positive rate of myotonic discharges of abductor pollieis brevis was 87.5~. The positive rate of myotonic discharges of extensor digitorum communis was 77.8~. The positive rates of myotonic discharges of anterior tibial muscle,quadriceps femoris and trian gular muscle are 57.1~ ,45.5~ and 45.5~ respectively. Conclusion Myotonic dystrophy distinguished from other neuromuscular disease might be mainly based on myotonic discharges and myogenic damage. Myotonic discharges were mainly observed in the small hand muscles. However,the positive rate of abductor pollicis brevis, which has the highest chance of myotonic discharge, was less than 100%.