阔筋膜张肌肌电图在腰椎间盘突出症诊断中的价值

The EMG of tensor fascia value in the diagnosis of lumbar disc herniation

目的：观察腰椎间盘突出症（LDH）患者阔筋膜张肌与臀大肌、臀中肌肌电图（EMG）上的自发电位阳性比例、运动单位电位（MUP）时限及波幅差异，了解其临床诊断价值。方法：本次研究共纳入30例LDH患者作为观察组，另设30例正常人为对照组，两组受试者性别、年龄比较差异无统计学意义（P〉0．05），具有可比性。对每例受试者阔筋膜张肌、臀大肌、臀中肌分别收集30个MUP。去除10个基线不稳的MUP，将剩余20个作定量分析，计算其波幅、时限的平均值及标准差。凡出现自发电位、MUP时限波幅较正常组超过两个标准差的肌肉均定义为阳性。统计阔筋膜张肌、臀大肌、臀中肌的阳性率。结果：观察组阔筋膜张肌EMG表现出自发MUP的患者的比例显著高于臀大肌、臀中肌，其MUP时限、波幅与臀大肌、臀中肌相比差异无显著意义（P〉0．05），阔筋膜张肌、臀大肌、臀中肌MUP时限、波幅与正常组相比差异均有显著意义（P〈0．05）。结论：阔筋膜张肌EMG对于LDH患者的定位诊断价值明确，其自发电位出现比例高于臀大肌、臀中肌与样本量不足有关，需增加样本量以作进一步的研究。

Objective：To stexplore the clinical diagnostic value of the positive proportion,motor unit potential（MUP） time limit and amplitude difference of spontaneous potentials in electromyogram （EMG） by observing patients with tensor fascialata, gluteus maximus of lumbar disc herniation（LDH）. Methods：30 patients with LDH were involved in this study as the observation group,and 30 normal people as the control group. There was no statistical significance between both groups in disease course and age （P〉0.05）, which demonstrated their comparability. Among 30 MUPs of tensor fascia lata, gluteus maximus and gluteus medius in each subjest,the remaining 20 were used for quantitative analysis while 10 MUPs of the most unstable base line were excluded. The average value and standard deviation of amplitude and time limit of the 20 cases were calculated, Positive results were defined as spontaneous potentials it two standard deviations of MUP amplitude exceeded fhat of the control group. Positive rates of tensor fascialata,gluteus maximus and gluteus madius were counted. Results：Significantly more spontaneous potentials appeared in tensor fascia lata than gluteus maximus and gluteus medius in the observation group. the time limit of MUP,amplitude and tensor fascia lala indicated no significant difference compared with gluteus maximus and gluteus madius（P〉0. 05） ,while there was significant difference in MUP time limit and amplitude of tensor fascia lata,gluteus maximus and gluteus madius compared with the control group （P〈0.05）. Conelusion：EMG of tensor fascia lata has a definite value in making topical diagnosis of patients with LDH, whose spontaneous potentials present more frequently than those of gluteus maximus and gluteus madius,which may result from insufficient sample size. Further study required suffilient sam ples.