脑卒中后发生肩-手综合征的神经电生理研究

Study on the electrophysiological features of shoulder hand syndrome after stroke

目的：分析脑卒中后发生肩-手综合征患者的神经电生理特征。方法选取脑卒中患者70例，按照其是否发生肩-手综合征将其分别定义为观察组与对照组，其中对照组患者38例，观察组患者32例。所有患者在住院期间均进行正中神经的针极肌电图和神经传导测定，观察并比较两组患者针极肌电图检查结果、感觉神经动作电位变化结果，并进行统计分析。结果观察组患者经针极肌电图检查后发现，所有患者均出现异常电位（如纤颤电位、正锐波），其中，对照组患者纤颤电位例数为2（5．26％），观察组为21（65．63％），观察组明显高于对照组（χ2＝6．954，P ＝0．026）；对照组患者正锐波例数为1（2．63％），观察组为11（34.38％），观察组明显高于对照组（χ2＝8．323，P＝0．014）。神经传导测定结果显示，观察组患者的感觉神经动作电位波幅显著低于对照组，且观察组患者的感觉神经波幅下降程度显著大于对照组。观察组患者平均感觉神经动作电位为（7．48±4．12）ms，明显低于对照组患者的（12.53±1．61）ms，观察组波幅下降程度明显高于对照组（t＝12．064，P＝0．017）。结论脑卒中后发生肩-手综合征患者的神经电生理指标发生显著变化，因此可进一步为早期发现脑卒中后肩-手综合征提供理论依据。

Objective To analyze the nerve electrophysiological characteristics of stroke occurrence shoulder hand syndrome patients.Methods A total of 70 stroke patients hospitalized in the Department of Neurology of Ruian City Red Cross Hospital were selected.According to whether the occurrence of shoulder hand syndrome,the patients were defined as the observation group （32 cases） and the control group （38 cases）.All patients during hospitalization received the median nerve needle electromyography and nerve conduction determination.The needle pole electromyo-gram examination results, sensory nerve action potential changes were observed and compared in the two groups. Results （1） After needle electromyography,all patients in the observation group showed abnormal potential （ such as fibrillation potentials was sharp waves）.Among them,fibrillation potential observed in 2 cases（5.26%） in the control group,which was significantly lower than 21 cases （65.63%） in the observation group （χ2 =6.954,P=0.026）.Positive sharp wave observed in 1 case（2.63%） in the control group,which was significantly lower than 11 cases （34.38%） in the observation group （χ^2 =8.323, P =0.014 ） .Nerve conduction measurement results showed that the sensory nerve action potential amplitude of the observation group was significantly lower than that of the control group, and amplitude of sensory nerve in the observation group decreased more significantly than the control group.The average sensory nerve action potential of the observation group was （7.48 ±4.12） ms,which was significantly lower than （12.53 ±1.61）ms of the control group,amplitude of wave in the observation group decreased more significantly than the control group （ t =12.064, P =0.017 ） .Conclusion Shoulder hand syndrome nerve electrophysiological parameters changed significantly after stroke occurrence.Therefore,it can be used further for the early found brain after stroke shoulder hand syndrome and provide a theoretical basis.