颈部脊髓损伤对患者双下肢神经传导功能的影响

Effects of cervical spinal cord injury on the nerve conduction function in lower limbs

目的:观察颈部脊髓损伤(SCI)后双下肢周围神经传导功能的变化,并比较完全性颈部SCI和不完全性颈部SCI之间的差异。方法:分别检测20例完全性颈部SCI患者、20例不完全性颈部SCI患者以及20例正常成年男性的胫神经、腓总神经、腓肠神经、隐神经的神经传导潜伏期、波幅和传导速度。结果:(1)运动神经:完全性损伤组和不完全性损伤组的末端运动神经潜伏期(DML)延长、运动神经传导速度(MCV)降低,与正常组比较有显著性差异(P<0.05),但其异常率都低于10%;完全性损伤组和不完全性损伤组的复合肌肉动作电位(CAMP)降低,与正常组比较有显著性差异(P<0.05),其异常率都高于20%,且完全性损伤组CAMP异常率高于不完全性损伤组(P<0.05)。(2)感觉神经:完全性损伤组和不完全性损伤组的感觉神经动作电位(SNAP)波幅降低、感觉神经传导速度(SNCV)降低,与正常组比较有显著性差异(P<0.05),但其异常率为0。结论:颈部SCI患者双下肢运动神经存在轴索变性,完全性损伤比不完全性损伤更重,感觉神经无明显异常。

Objective： To observe the changes of peripheral nerve conduction function of lower limbs in patients with cervical spinal cord injury（SCI）, and to compare the differences between complete cervical SCI and incomplete cervical SCI.Method： To detect the neural conduction latency, amplitude and velocity of the tibial nerve, peroneal nerve, sural nerve and saphenous nerve for 20 cases of complete cervical SCI patients, 20 cases of incomplete cervical SCI patients and 20 cases of normal adult male.Result：（1） Motor nerve： statistically significant results in comparison to normal group included a prolonged distal motor latency（DML） and a diminished motor conduction velocity（MCV） in the complete injury group and incomplete injury group（P〈0.05）, but their abnormal rate is below 10%. Statistically significant results in comparison to normal group included a diminished compound muscle action potential（CMAP） in the complete injury group and incomplete injury group（P〈0.05）, and their abnormal rate is 20% higher. And the abnormal rate of complete injury group is higher than that of incomplete injury group.（2） Sensory nerve： statistically significant results in comparison to normal group included a diminished sensory nerve action potential（SNAP） amplitude and sensory nerve conduction velocity（SNCV） in the complete injury group and incomplete injury group（P〈0.05）, but their abnormal rate is 0.Conclusion： There is axonal degeneration in the lower limbs of the patients with cervical SCI and more severe axonal degeneration occurs in the complete cervical SCI. There is no obvious abnormality in sensory nerve.