正常成人咽期吞咽相关肌群的表面肌电图研究

Surface electromyography studies of swallowing-related muscles during pharyngeal swallowing in normal subjects

目的探讨不同年龄段正常成人咽期吞咽相关肌群肌电活动的平均肌电值（AEMG）与年龄及吞咽模式的关系。方法选取200名正常成人受试者，按年龄不同将其分为A组（18～30岁）、B组（30～50岁）、C组（50～70岁）、D组（≥70岁组），4组人数分别为59例、50例、49例、42例。采用表面肌电图（sEMG）技术测量受试者静息状态、空吞咽、吞咽5ml水、吞咽20ml水时相关肌群肌电活动的AEMG，分析其不同差异。结果静息状态、空吞咽、吞咽5ml水及吞咽20ml水的情况下，4组受试者颏下肌群及舌骨下肌群AEMG之间比较，差异均无统计学意义（P〉0．05）。组内比较发现，A组及B组受试者空吞咽、吞咽5ml水及吞咽20ml水时颏下肌群及舌骨下肌群AEMG间两两比较，差异均无统计学意义（P〉0．05）。C组受试者吞咽5ml水时颏下肌群的AEMG[（28．0±7．80）μV]及舌骨下肌群的AEMG[（27．9±7．20）μV]与组内空吞咽时的AEMG比较，差异均无统计学意义（P〉0．05），吞咽20ml水时颏下肌群的AEMG[（32．7±9．00）μV]及舌骨下肌群的AEMG[（31．6±8．50）μV]与组内空吞咽比较，差异均有统计学意义（P〈0．05），且C组受试者吞咽20ml水时颏下肌群及舌骨下肌群的AEMG高于组内吞咽5ml水时的AEMG（P〈0．05）。D组受试者吞咽5ml水时颏下肌群及舌骨下肌群的AEMG与组内空吞咽时的AEMG比较，差异均无统计学意义（P〉0．05），吞咽20ml水时，颏下肌群及舌骨下肌群的AEMG均高于组内空吞咽及吞咽5ml水时的AEMG（P〈0．05）。结论正常成人咽期吞咽相关肌群肌电活动的AEMG与年龄变化无关，与吞咽模式有关。

Objective To investigate the relationship between the average amplitude of swallowing-related muscles during pharyngeal swallowing and age and swallow model of healthy adults in different age groups. Methods A total of 200 healthy adults were recruited and divided into 4 age groups ： group A （ 18 - 30 years old, n = 59 ） , group B （30 - 50 years old, n = 50） , group C （50 - 70 years old, n = 49） and group D （70 years old, n = 40）. Surface electromyography was used to acquired the average amplitude of electrical activity of the muscles during three swallow models： resting state, voluntary single swallows of saliva （dry swallowing） , voluntary single swallows of 5 ml water at once （wet swallowing）and voluntary single swallows 20 ml water at once. The mean value of the average amplitude of normal adults of different ages were calculated and analyzed. Results ①Intergroup comparison showed no difference in the average amplitude of submental muscles and infrahyoid muscles among the 4 age groups （ P 〉 0.05 ） in all the three swallowing models ;②Intra-group comparison showed that, there were no statistical differences in the average amplitude of submental muscles among the three swallow models between groups A and B （ P 〉 0.05 ）. In group C, there were no statistical differences between dry swallowing and wet swallowing of 5 ml of water in terms of the average amplitude of submental muscles and infrahyoid muscles during dry swallowing. （P 〉 0. 05） , however, but there exis- ted statistical differences in terms of the average amplitude of submental muscles and infrahyoid muscles, when comparing dry swallowing with voluntary single swallowing 20 ml water at once（ P 〈 0.05 ）. The average amplitude of submental muscles and infrahyoid muscles during swallowing of 20 ml water were significantly higher than that during wet swallowing（P 〈0.05 ）. In group D, there was no difference between drying swallow and wet swallowing（ P 〉 0.05 ） in terms of the mean sEMG amplitude of the muscles,but all lower than swallowing 20 ml of water,with a statistically significant differences（P 〈 0.05）. Conclusions The sEMG amplitude in swallowing-related muscles during pharyngeal swallowing is not related to age, but swallowing models.