肌病患者膈肌肌电图初步研究

A primary study of diaphragmatic electromyography in myopathic patients.

目的 初步探讨膈肌肌电图 (DEMG)在肌病患者的应用及特点。方法 以同心圆针电极用肋间隙进针法分别记录屏气、平静吸气和深吸气时 3 0例肌病患者和 13例 2 2块健康对照者的膈肌肌电活动。19例患者同时接受用力肺活量百分比 (%FVC)测定。结果 所有受检者均无任何并发症。与对照者相比 ,肌病患者屏气时可见纤颤电位及正锐波等自发电位 ;平静吸气时膈肌运动单位动作电位时限和去多相时限均缩短、面积对数减少、波幅对数、多相波和卫星电位无明显变化。自发电位与临床呼吸困难和 %FVC相关。去多相时限异常率高于临床呼吸困难出现率。结论 针极DEMG能从电生理角度评价肌病患者呼吸功能 ;

Objective To investigate the characteristics of diaphragmatic electromyogram (DEMG) of myopathic patients and their diagnostic implications. Methods The electromyograms of 30 diaphragms of 30 myopathic patients and 22 diaphragms of 13 healthy controls were recorded by inserting a concentric needle electrode through the intercostal space, when they were in breath holding, eupnia and deep breathing, respectively. The percentage of forced vital capacity (%FVC) was assessed in 19 myopathic patients at the same time. Results No side effect was observed in any of the subjects during the study. The spontaneous activities such as fibrillation and positive sharp wave could be observed when myopathic patients held their breath. During the period of smooth breath, the durations calculated with and without polyphasic pattern of the diaphragmatic motor unit action potentials (DMUAP) in myopathic patients were shorter than those in the controls, and the common logarithmic value of the DMUAP area and amplitude were smaller than those in the controls, the number of polyphasic DUMAP and satellite potentials was similar to that in the controls. The spontaneous activities were correlated with clinical dyspnoea and %FVC. The abnormal rate of the duration calculated without polyphasic pattern was higher than the incidence of clinical dyspnoea in the myopathic patients. Conclusion DEMG could be used to evaluate the respiratory function of myopathic patients at the electrophysiologic level, with the duration and the spontaneous activity as its sensitive indices.