中国医科大学学报

中国医科大学学报

中国医科大学学报 ›› 2016, Vol. 45 ›› Issue (8): 715–718.doi: 10.12007/j.issn.0258-4646.2016.08.011

• 论著 • 上一篇    下一篇

脊髓亚急性联合变性患者临床神经损害相关因素及电生理特点分析

金娟 1,李妍 1,朱皓月 1,赵珊珊 1,曲慧玲 2,赵传胜 1   

  1. 1 中国医科大学附属第一医院神经内科,沈阳 110001;2 辽宁省人民医院神经内科,沈阳 110016
  • 收稿日期:2015-12-30 出版日期:2016-08-20 发布日期:2016-07-23
  • 通讯作者: 赵传胜 E-mail:cszhao@mail.cmu.edu.cn
  • 作者简介:金娟(1989 -),女,硕士研究生 .
  • 基金资助:
    辽宁省自然科学基金(201202276)

Relevant Factors of Clinical Neural Lesions and Electrodiagnostic Features on Patients with Subacute Combined Degeneration of Spinal Cord

JIN Juan1,LI Yan1,ZHU Haoyue1,ZHAO Shanshan1,QU Huiling2,ZHAO Chuansheng1   

  1. 1 Department of Neurology,The First Hospital,China Medical University,Shenyang 110001,China;2 Department of Neurology,People′s Hospital of Liaoning Province,Shenyang 110016,China
  • Received:2015-12-30 Online:2016-08-20 Published:2016-07-23

摘要: 目的 回顾性研究脊髓亚急性联合变性(SCD)患者临床神经损害相关因素及神经电生理相关特点。方法 选取 2013 年 1 月至 2015 年 7 月就诊于中国医科大学附属第一医院神经内科既往未进行治疗,最终确诊为 SCD 的患者(29 例)作为研究对 象,分析其神经损害程度与病程、血清 VB12 水平之间的相关性;总结分析其临床及电生理资料。结果 患者病程(8.11±11.65) 个月,与 SCD 神经损害程度显著相关(P = 0.001);血清 VB12(62.69±44.84)pmol/L,与神经损害程度无显著相关(P > 0.05)。电生 理资料显示,共检测神经 256 条,运动神经异常率(15.20%)低于感觉神经(42.75%),差异有统计学意义(P < 0.001);上肢神经异 常率(27.10%)低于下肢神经(30.87%),但差异没有统计学意义(P = 0.578);运动神经中各神经(尺神经、正中神经、胫神经、腓 总神经)损害异常率无统计学差异(P = 0.320),感觉神经中各神经(尺神经、正中神经、胫神经、腓肠神经、腓浅神经)损害异常率 无统计学差异(P = 0.755);在肌电图记录的各个参数分析中,运动神经中各神经在复合肌肉动作电位波幅(CAMP)参数上损害 异常比较差异有统计学意义(P = 0.005);感觉神经中各神经在 CAMP、未引出参数上损害异常比较差异有统计学意义(均 P <0.001)。结论 SCD 神经损害程度与病程长短存在显著相关性;感觉神经较运动神经更易受累;运动神经中腓总神经在 CAMP上较其他神经更易受累;感觉神经中胫神经在 CAMP 上较其他神经更易受累,且胫神经整体受累程度较重。

关键词: 脊髓亚急性联合变性, 维生素 B12, 神经损害, 电生理学

Abstract: Objective To retrospectively study the clinical and electrodiagnostic features in subacute combined degeneration of spinal cord(SCD)patients. Methods The clinical and electrodiagnostic recordings of all SCD patients conformed in our Neurology Department from January 2013 to July 2015 were retrospectively reviewed. Totally 29 patients diagnosed as SCD,whom received no treatment before admitted in our hospital,were recruited for the study. Correlation analysis between serum level of vitamin B12(VB12),course of disease and degree of neural lesion was performed,and the electrodiagnostic features were summarized and analyzed. Results The course of disease had significant correlation with the degree of neural lesion(P = 0.001),but there was no significant relevance between serum VB12 level and neural damage(P > 0.05). Electrodiagnostic examination revealed:The abnormal rate of motor nerve(15.20%)was lower than that of sensory nerve(42.75%,P < 0.001)and the up- per limb nerve(27.1%)was lower than that of lower limb nerve(30.87%,P = 0.578). There was no remarkable difference of abnormal rate in all kinds of nerves of motor and sensory nerve(P1=0.320,P2=0.755). In the analysis of the parameters of electromyograph,there was statistical significance of the abnormal rates of compound muscle action potential(CAMP)between each motor nerve(P = 0.005). There was statistical significance of the abnormal rates of CAMP and no function between each sensory nerve(all P < 0.001). Conclusion The course of disease has significant correlation with the degree of neural lesion. Sensory nerve is tended to be betreffend than motor nerve. Phil.always nervous are more likely to be affected than others in motor nerve at CAMP. Tibial nerve is easier to be influenced at CAMP in sensory nerve,and the lesion is more serious.

Key words: subacute combined degeneration of spinal cord, vitamin B12, neural lesion, electrophysiology

中图分类号: 

  • R744.6
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