老年无症状腔隙性脑梗死患者咽期吞咽功能的表面肌电特点

Pharyngeal Swallowing Function in Elderly Patients with Asymptomatic Lacunar Infarction:Surface Electromyography Study

目的利用表面肌电(sEMG)技术观察无症状腔隙性脑梗死(LI)患者咽期吞咽相关肌群在不同吞咽模式下肌电活动的特点。方法 2015年1月至2017年1月,连续性收集临床诊断为LI且无吞咽障碍主诉老年患者(LI组)32例以及性别年龄匹配的正常老年人(正常组)30例。应用表面肌电技术与分析系统,记录受试者不同吞咽模式下舌骨下肌群、颏下肌群肌电活动振幅的均方根(RMS)。结果两组组内舌骨下肌群、颏下肌群RMS在不同模式下均存在非常高度显著性差异(F>110.67,P<0.001)。放松模式和干吞咽模式下,两组间舌骨下肌群、颏下肌群RMS均无显著性差异(t<1.484,P>0.05)。20 ml含水吞咽模式下,LI组颏下肌群RMS明显低于正常组(t=3.334,P<0.01),舌骨下肌群RMS有降低趋势,但无显著性差异(t=1.871,P>0.05)。100 ml连续饮水模式下,LI组舌骨下肌群、颏下肌群RMS均明显低于正常组(t>3.118,P<0.01)。结论无症状LI患者吞咽功能较正常同龄人减退;sEMG技术可用于对其吞咽功能进行评估。

Objective To observe the surface electromyography（sEMG） characteristics of pharyngeal swallowing muscles in different swallowing modes in asymptomatic lacunar infarction（LI） patients.Methods From January,2015 to January,2017,a total of 32 asymptomatic LI patients（LI group） aged over 60 years were consecutively collected,and 30 normal old subjects matched with age and gender（normal group） were also enrolled.The amplitudes of sEMG activity of infrahyoid muscles and submental muscles in different swallowing modes were recorded,and the root mean square（RMS） was analyzed.Results Significant difference was found in both muscle groups in different swallowing modes in both groups（F110.67,P〈0.001）.There was no significance in the RMS in both two muscle groups in rest and dry swallowing modes between two groups（t1.484,P〈0.05）.In the 20 ml water swallowing mode,the RMS was lower in the submental muscles in the LI group than in the normal group（t=3.334,P〈0.01）,and no significant difference was found in the infrahyoid muscles（t=1.871,P〈0.05）.In the 100 ml continuous drinking mode,the RMSs were significantly lower in both two muscle groups in LI group than in the normal group（t3.118,P〈0.01）.Conclusion Swallow abilities decrease in asymptomatic LI.sEMG could be used to evaluate their swallowing function.