有机磷中毒致周围神经损害的电生理研究

Electrophysiological Study of Peripheral Nerve Damage Caused by Organophosphate Poisoning

目的：对有机磷中毒致周围神经损害的电生理影响进行研究。方法选择2013年5月～2014年5月期间收治的100例有机磷中毒患者为研究对象，收集患者相应的病例资料，对每位患者的大鱼际肌、小鱼际肌、三角肌、趾短伸肌、胫前肌、腓肠肌进行常规肌电图（electromyography，EMG），统计静息状态、轻及重收缩状态下的运动单位；对正中神经、尺神经、腓深神经、胫神经的运动神经传导速度（motor nerve conduction velocity，MCV）和感觉神经传导速度（sensory nerve conduction velocity，SCV）进行测定，并与正常MCV、SCV对比，同时统计神经异常发生情况。结果（1）静息状态下纤颤发生率为30.8%，正向电位发生率为31.8%；轻收缩时运动单位电位时限延长、波幅增高、多相波增多发生率分别为22.8%、23.0%、20.8%；重收缩时募集形式单纯相占38.2%，混合相为44.3%，干扰相为17.5%，均表现为周围神经损害。（2）MCV异常率为24.3%，SCV异常率为31.3%，与正常参考值比较，MCV、SCV减慢，且差异具有统计学意义（P〈0.05），MCV检测中有97条神经检测异常，异常率为24.3%，SCV检测有125条神经检测异常，异常率为31.3%，SCV神经异常率高于MCV，但差异无统计学意义（P〉0.05）。结论电生理检查可以为有机磷中毒患者所致的周围神经损伤情况提供重要的统计依据，为临床诊断、鉴别提供评判指标，具有重要的临床判断价值。

Objective To study electrophysiological effects of organophosphorus poisoning caused by peripheral nerveinjury.MethodsSelected 100 cases of organophosphorus poisoning patients as the research object. Compared with routine EMG,MCV and SCV,also statistical recorded neural abnormal. Results （1）the resting state fibrilation occurred rate was 30.8%,the positive potential occurrence rate was 31.8%,light contraction prolonged duration of motor unit potentials and the amplitude increased,polyphase wave increased,strong contraction showed for peripheral nerve damage. （2） MCV and SCV decreased significantly than the normal reference value,and the difference were statistical significance（P〈 0.05）,the abnormal rate of SCV than MCV,but the difference was not statisticaly significant（P〉 0.05）.Conclusion Provide statistical basis of important electrophysiological examination of peripheral nerve injury can be caused by organophosphate poisoning.