肩手综合征的拇短展肌联合第1骨间肌电生理研究

Electrophy Siological Study of Abductor Pollicis Brevis Combined with First Dorsal Interosseous in Should-Hand Syndrome after Stroke

目的:经由对脑卒中后肩手综合征(shoulder-hand syndrome,SHS)患者开展神经电生理测定,来评估诊断SHS患者中周围神经电生理指标的应用价值。方法:30例脑卒中并发SHS急性期患者(SHS组)、20例脑卒中无SHS患者(N-SHS组)分别进行拇短展肌、第1骨间肌、正中神经的针极肌电图(EMG)和神经传导速度测定。结果:SHS组30人(90%)针极肌电图(EMG)检查见插入电位异常,正锐波与纤颤电位,异常率较对照组明显偏高。SHS组患侧正中神经运动传导速度(NCV)和感觉传导速度(SCV)减慢、复合肌肉动作电位波幅(CMAP)减低(P<0.05);末端运动潜伏期(DML)无显著性差异(P>0.05)。结论:电生理检查用于诊断SHS的周围神经损害是比较敏感的,可以提高早期SHS的检出率。

Objective:The investigations revealed the role of peripheral nerve damage in the pathogenesis of post-stroke shoulder hand syndrome(SHS)by analyzing the electrophysiological features of clinically diagnosed patients with SHS.Methods:30 stroke patients with SHS in the acute stage were selected as SHS group,and 20 stroke patients without SHS were selected as N-SHS group.The motor nerve conduction and the needle electromyogram(EMG)test were performed for standard sensory,the abductor pollicis brevis and first dorsal interosseous with 50 of the patients.Results:The abnormal insertion potential,fibrillation potential and positive sharp wave were detected in 30 cases(90%)of SHS group,and the abnormal rate was significantly higher than that of control group.In SHS group,NCV and SCV of median nerve were decreased and CMAP was decreased(P<0.05).There was no significant difference in DML(P>0.05).Conclusion:Peripheral nerve damage was found in the shoulder-hand syndrome patients,which was mainly axonal degeneration.