健康人肌电图干扰相转折-波幅云图参考值及影响因素

Developing turns-amplitude clouds for healthy Chinese： reference values and influence factors

目的 建立健康国人常用肌肉肌电图干扰相转折-波幅云图参考值,并讨论可能影响云图形态的因素.方法 于2017年7-12月在南方医科大学南方医院院内以公开招募的形式招募59名健康志愿者,包括男性34名及女性25名,分别按年龄分为青年组（15～39岁）、中年组（40～64岁）、老年组（≥65岁）.使用同心圆针电极采集胸锁乳突肌、三角肌、肱二头肌、伸指总肌、小指展肌、股四头肌、胫前肌、腓肠肌8块肌肉干扰相肌电信号,计算机自动分析每个记录点转折数/s和平均波幅,以lg转折数为自变量、lg（平均波幅-100）为因变量做直线回归拟合,获得云图参考值.使用邹至庄断点检验比较肌肉、性别、年龄、优势侧肢体等因素对云图形状的影响.结果 建立了健康国人上述肌肉转折-波幅云图参考值,发现肌肉、年龄是影响云图形态的主要因素,性别可能影响部分云图形态,优势侧肢体对云图形态影响不大.结论 肌电图干扰相转折-波幅云图参考值具有临床实际意义.

Objective To establish the reference values and evaluate influence factors of turns-amplitude clouds for healthy Chinese.Methods We recruited 59 healthy subjects From July 2017 to December 2017 in Nanfang Hospital,Southern Medical University,including 34 males and 25 females,who were divided into young group （15-39 years old）,middle-aged group （40-64 years old） and the elderly group （over 65 years）,respectively.The number of turns （NT） and mean amplitude （MA） normative data of sternocleidomastoid muscle,deltoid muscle,biceps brachii muscle,extensor digitorum muscle,abductor digiti minimi muscle,quadriceps femoris muscle,tibialis anterior muscle,and gastrocnemius muscle were obtained by using concentric needle electrodes.A total of 20-30 records were collected from each muscle in different degree of contraction.A linear regression of lg（MA-100） versus lgNT was made and the slope,intercept,the 95% confidence interval of intercept,the largest MA and largest NT were calculated for each muscle.The influence factors,such as gender,age,muscles,and dominant limbs on the shape of cloud were evaluated by using the Chow breakpoint test.Results Normal turns-amplitude clouds were obtained and presented in this article.Muscle and age were found to be the main influence factors affecting the shape of cloud,and gender may affect some clouds,while the dominant limbs had little influence on the shape of the cloud.Conclusion The reference values of turns-amplitude cloud based on muscle,gender and age are of practical significance in clinic.