先天性肌性斜颈患儿胸锁乳突肌表面肌电信号特征研究

Characteristics of surface electromyography of sternocleidomastoid in infants with congenital muscular torticollis

目的 探讨先天性肌性斜颈（CMT）双侧胸锁乳突肌的表面肌电信号特征.方法 选择60例CMT患儿作为CMT组,并根据病变部位分为左CMT组和右CMT组,另以15例健康儿童作为对照组,检测各组研究对象在5个体位（仰卧中立位、颈部左右旋转和左右侧屈）下双侧胸锁乳突肌的肌电信号,进行时域均方根值（RMS）分析.结果 仰卧中立位时,CMT组患侧胸锁乳突肌的RMS值为8.7±4.4,低于健侧的16.3 ±6.4（t=11.118,P＜0.01）.颈部旋转和侧屈时,CMT组患侧胸锁乳突肌的RMS值低于健侧（P＜0.05）;CMT组双侧胸锁乳突肌RMS值均明显增加,但患侧增加的RMS值明显低于健侧（t=6.239,P＜0.01）.仰卧中立位时,对照组左侧胸锁乳突肌的RMS值为13.1 ±7.1,右侧为12.7±6.8,双侧差异无统计学意义（P＞0.05）;颈部旋转和侧屈时,对照组双侧胸锁乳突肌RMS值差异无统计学意义（P＞0.05）;双侧胸锁乳突肌RMS值也均增加,但两侧增加的RMS值差异无统计学意义（P＞0.05）.结论 表面肌电信号检测显示CMT患侧肌肉运动单位激活、募集和参与活动的数量较少,肌肉兴奋性差.左CMT和右CMT患儿的胸锁乳突肌表面肌电信号特征表现一致.

Objective To investigate the characteristics of surface electromyography （sEMG） of bilateral sternocleidomastoid in infants with congenital muscular torticollis （CMT）.Methods Sixty CMT infant patients （CMT group） and 15 healthy infants （control group） were enrolled in this study.The CMT patients were divided into left and right CMT subgroups according to the affected side.The sEMG signals of bilateral sternocleidomastoid during cervical neutral,left and right rotation and lateral flexion posture in the supine position were collected,and the root mean square （RMS） was analyzed.Results The RMS value of the affected and unaffected sternocleidomastoid was （8.7 ± 4.4） and （16.3 ± 6.4）,respectively in CMT group during cervical neutral in the supine position,and the RMS value of the affected side was significantly lower than that of the unaffected side（t =11.118,P 〈0.01）.During cervical rotation and lateral flexion,the RMS value of the affected sternocleidomastoid was significantly lower than that of the unaffected side （P 〈 0.05）,and the RMS values of bilateral sternocleidomastoid were significantly increased,but the increased RMS value of the affected side was significantly lower than that of the unaffected side in CMT group （t =6.239,P 〈0.01）.The RMS value of left and right sternocleidomastoid was（13.1 ±7.1）and （12.7 ± 6.8）,respectively（P 〉 0.05）in control group during cervical neutral in the supine position.During cervical rotation and lateral flexion,there were no significant differences in the RMS values of bilateral sternocleidomastoid,and the RMS values of bilateral sternocleidomastoid were significantly increased,but there was no significant difference in the increased RMS value of bilateral sternocleidomastoid in control group（P 〉 0.05）.Conclusion The sEMG characteristics in infants with CMT show that the amount of motor units of the affected sternocleidomastoid which is activated,raised and involved in motions are less,and the muscle excitability is poor.The sEMG characteristics of left and right CMT are consistent.