新疆爆发式流行性脊髓灰质炎的肌电图和神经电图分析

Outbreak of epidemic poliomyelitis in Xinjiang patients： an electromyogram analysis

目的 探讨新疆和田输入性脊髓灰质炎野病毒所致急性弛缓性瘫痪（AFP）即急性脊髓灰质炎综合征的肌电图改变. 方法 选取自201 1年7月至2012年9月新疆维吾尔自治区人民医院神经内科收治的26例0～65岁急性脊髓灰质炎患者进行肌电图检查. 结果 患者病前大都有呼吸道或消化道病毒感染史;以双下肢弛缓性瘫痪为主,肌力大都在0～2级,腱反射减弱,无感觉障碍.有14例血粪便阳性.26例患者中双下肢运动神经传导速度（MCV）异常,H波出现率降低或未引出,感觉神经传导速度（SCV）正常,肌电图示神经源性损害;双上肢神经传导速度正常或偏低值,F波正常或出现率低,5例肌电图示可疑神经元性损害.患者预后均较差. 结论 肌电图对此次急性脊髓灰质炎I型野病毒所致AFP有重要辅助诊断价值.

Objective To analyze the electromyogram （EMG） changes of patients with acute flaccid paralysis （AFP） in Hetian Xinjiang.Methods Twenty-six patients with acute poliogmyelitis,admitted to our hospital from July 2011 to September 2012,were chosen in our study; their clinical data were analyzed,and they all underwent EMG examination.Results Most patients had contact with respiratory virus or digestive virus prior to illness onset.Most of patients had flaccid paralysis,muscle strength between 0 and 2 grades,tendon reflex being abated and no sensory disturbance.Fourteen patients had positive blood stool.Motor nerve conduction velocity （MCV） was abnormal,H-reflex was decreased or not educed and sensory nerve conduction velocity was normal in lower limbs of the 26 patients; EMG showed myogenic abnormality.Nerve conduction velocity was normal or low and Fwave was normal or decreased in upper limbs; EMG showed neurogenic abnormality in five of the 26 patients.Poor prognosis was concluded in all the patients.Conclusion EMG has important diagnosis value in AFP induced by polio wild-type I.