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1.
运动神经元病的单纤维肌电图的研究   总被引:1,自引:0,他引:1  
目的研究单纤维肌电图(SFEMG)对运动神经元病的辅助诊断价值及探讨单纤维肌电图异常率与其病型、病情的关系。方法应用单纤维肌电图技术对48例运动神经元病(MND)患者,24例颈椎性脊髓病(CSM)患者及42名健康正常受试者进行研究。结果MND患者的SFEMG阳性率为73%,CSM患者的SFEMG阳性率为4%。结论SFEMG有助于鉴别MND与CSM。SFEMG异常率与病型无关,与病情有关,提示MND存在明显的神经肌肉接头传递功能障碍。  相似文献   

2.
目的探讨外周血白细胞变形能力(LD)和白细胞粘附功能(LAF)的变化与急性脑梗塞病情的相关性。方法检测68例急性脑梗塞患者发病后第3、7、15、21天和60例健康人LD和LAF的变化。结果急性脑梗塞患者LD明显降低,LAF明显增高。与对照组比较有显著差异(P<0.001),且病程在第3天前LD和LAF变化更明显。有并发症患者LD和LAF变化较无并发症者更明显(P<0.001)。结论LD降低和LAF增高与急性脑梗塞病情变化有关。  相似文献   

3.
帕金森病患者智能障碍及其相关因素分析   总被引:3,自引:0,他引:3  
目的 研究帕金森病(PD)患者智能障碍与年龄、性别、病程、脑萎缩、脑功能和了局部血流量(rCBF)的相关性。方法 采用长谷川简易智能评价分度表(HDS)测试76例PD患者智能,并检查其头颅CT,脑电地形图(BEAM)和^133Xe吸入法测定rCBF。结果 智能障碍PD患者,HDS值与年龄呈负相关(r=-0.71,P〈0.01),与大脑平均血流量呈正相关(r=0.67,P〈0.01);而与性别和病程  相似文献   

4.
线粒体肌病与其它神经肌病破碎红纤维的对比研究   总被引:1,自引:0,他引:1  
为了探讨破碎红纤维(RRFs)对线粒体肌病的诊断价值,对线粒体肌病、多发性肌炎/皮肌炎(PM/DM)和脊髓性肌萎缩(SMA)3组病人RRFs的形态特点和出现频率进行了对比研究,同时对3组病人线粒体的超微结构改变进行了对比观察。结果发现总RRFs出现频率线粒体肌病组3.0%~15.2%,PM/DM组5.2%~11.1%,SMA组4.5%~49%。线粒体肌病组以典型RRFs为主,PM/DM组以均匀红染纤维为主,SMA组以红边纤维为主。线粒体的超微结构观察发现线粒体肌病组线粒体形态改变、嵴排列异常及嵴内包涵体多见,受累线粒体较多。PM/DM组和SMA组线粒体主要改变是数量增多,形态变小,而外形改变和嵴排列异常少见。未见嵴内包涵体。本研究结果提示RRFs及出现频率不能作为诊断线粒体肌病的形态学标准,典型RRFs对线粒体肌病的诊断较有价值。电镜观察线粒体超微结构改变的不同特点有助于线粒体肌病的鉴别诊断  相似文献   

5.
采用放射免疫法检测8例帕金森病(PD)和13例具帕金森综合征的多系统萎缩(MSD)患者脑脊液(CSF)中β-内啡肽(β-EP)、亮脑啡肽(LEK)、强啡肽A_(1-13)(DynA_(1-13))含量。发现患者组CSF中β-EP和LEK含量显著高于对照组,DynA_(1-13)含量变化不显著。帕金森病和多系统萎缩两组间CSF中三种阿片肽含量相差不明显。提示且EP、LEK含量增高可能与PD和MSD患者所共有的肌张力增高和肌强直等锥体外系症状产生有关。  相似文献   

6.
探讨NF2基因缺失在散发脑膜瘤发病中的意义及其与不同组织学类型的相关性,为脑膜瘤分子水平分类提供依据。选取目前发现的与NF2基因连锁最为紧密的一个DNA多态标记(D22S268),就其在56例散发脑膜瘤中的杂合性缺失(lossofheterozygosity,LOH)进行研究。D22S268在散发脑膜瘤中的LOH率高达59.5%(25/42),其LOH率在纤维型脑膜瘤和合体细胞型脑膜瘤中存在显著差异,而在Ⅰ、Ⅱ、Ⅲ级脑膜瘤中不存在明显差异。NF2基因的失活可能是散发脑膜瘤发生中的早期事件,以缺失为主;与在纤维型脑膜瘤中不同,NF2基因的缺失在合体细胞型脑膜瘤发生中可能不起主要作用。  相似文献   

7.
肘肌的神经低频重复电刺激检查对诊断重症肌无力的价值   总被引:1,自引:0,他引:1  
本文应用肘肌神经重复电刺激检查(RNS)的方法。对34例确的重症肌无力(MG)病人进行检查。结果13例I型MG病人中有1例阳性。21例Ⅱ型和Ⅲ型MG病人中有12例阳性。同其它肌肉比较,RNS在肘肌阳性率明显高于小指外展肌,略高于斜方肌。作者建议可由肘肌代替近端肌肉完成RNS。在MG病人的诊断中,肘肌RNS的阳性率低于伸指总肌单纤维肌电图(SFEMG)的阳性率。  相似文献   

8.
目的:检测血清β淀粉样蛋白(β-AP)和多肽生长因子含量变化,探讨其在Alzheimer病(AD)和血管性痴呆(VD)发病机制中的可能作用。方法:采用放射免疫分析法(RIA)检测临床诊断为AD患者8例,VD患者15例及63例缺血性脑血管病(ICVD)患者血清β-AP、转化生长因子α(TGF-α)和类胰岛素样生长因子Ⅱ(IGF-Ⅱ)的水平,同时与健康对照组比较。结果:AD与VD患者β-AP、TGF-α和IGF-Ⅱ水平明显高于ICVD组和健康对照组,均具有显著性差异。ICVD患者血清β-AP、TGF-α和 IGF-Ⅱ水平亦明显高于对照组,其中以脑梗塞后遗症(SCI)和椎基底动脉供血不足(VBI)组增高十分明显,与对照组比较差异显著(P<0.05)。AD与 VD患者 3项测定指标之间具有明显的正相关。结论:①β-AP可能是AD和VD发病的危险因素。②引起AD和VD神经元毒性作用进而导致痴呆.这可能与TGF-α和IGF-Ⅱ增多有关。③β-AP与TGF-α、IGF-Ⅱ密切相关,在老年斑形成过程中可能起重要作用。  相似文献   

9.
帕金森病和载脂蛋白E基因多态性的相关研究   总被引:4,自引:0,他引:4  
目的探讨帕金森病(PD)和载脂蛋白E(ApoE)基因的相关性。方法用PCR-RFLP方法对52例PD病人ApoE基因型进行检测,并与正常组进行比较。结果PD组ApoE基因型分布与正常组有显著不同(P<001),PD病人的ε2和ε4的频率明显比正常人高,而ε3明显较正常人低。结论帕金森病ApoE基因型分布的差异可能与载脂蛋白E的代谢异常引起对神经损伤的修复能力降低有关,其结果可能导致PD的遗传易感性增加  相似文献   

10.
精神分裂症患者认知功能障碍的研究   总被引:8,自引:0,他引:8  
目的:探讨精神分裂症患者认知功能障碍特点及其影响因素,方法:应用Fuld物体记忆测验(FOM)、快速词汇测验(RVR)、积木测验(BD)和数字广义测验(DS)对88例精神分裂症患者认知功能状况进行评定。结果:精神分裂症患者FOM、RVR、BD和DS得分明显低于对照组,差异有显著性(FOM、RVR、BD,P〈0.001;DS,P〈0.005)。相关分析发现,RVR和BD与BPRS得分呈负相关,FOM  相似文献   

11.
目的探讨重复神经电刺激(RNS)与单纤维肌电图(SFEMG)在检测肌萎缩侧索硬化(ALS)患者神经肌肉接头功能紊乱中的吻合率及RNS低频递减阳性率与SFEMG指标纤维密度(FD)、颤抖(jitter)、阻滞(block)的关系。方法收集2008-5—2009-4在北京协和医院神经科门诊或病房确诊或拟诊的ALS患者43例,同时行RNS及SFEMG检查。比较RNS与SFEMG在判断ALS患者神经肌肉接头紊乱的敏感性和特异性,并分析RNS低频递减与SFEMG参数指标jitter、block、FD的相关性。结果(1)43例患者中26例RNS(+),占60.5%,17例RNS(-),占39.5%。SFEMG(+)34例,占79.1%,SFEMG(-)9例,占20.9%。其中SFEMG(+)+RNS(+)者共25例,SFEMG(-)+RNS(-)者8例。RNS在判断ALS存在神经肌肉接头受累方面与SFEMG比较有一定的吻合性(Kappa=0.47,P0.01)。(2)RNS阴性和阳性组FD间比较无统计学差异(t=-0.1405,P0.05)。RNS阳性组Block程度明显高于RNS阴性组(χ~2=11.432,P0.01),jitter值也明显高于RNS阴性组(t=2.906,P0.01)。桡神经RNS波幅递减程度与jitter值呈正相关(r=0.626,P0.05)。结论 RNS与SFEMG比较有一定的吻合率。RNS检查灵敏度较高,具有操作简单,费用低,耗时短,无创,不需患者特殊配合,近远端肌肉均可操作,易于推广的特点,对ALS患者的辅助诊断具有意义。  相似文献   

12.
Single fiber electromyography (SFEMG) measurements of fiber density and jitter are used in the diagnosis of a variety of peripheral nervous system disorders. However, the normal values of these measurements for most muscles and age groups are not well documented in the literature. We present a retrospective and prospective multicenter collection of SFEMG jitter and fiber density data from control subjects obtained for the purpose of defining reference values for many muscles and different ages. The data and calculated upper limits for fiber density, individual pair jitter, and mean jitter are presented for each muscle in tabular and graphical format, for different age groups.  相似文献   

13.
OBJECTIVE: Single fiber EMG (SFEMG) is a potent electrophysiological method to evaluate impaired neuromuscular transmission, and allows sensitive diagnosis of neuromuscular transmission abnormalities such as myasthenia gravis. The jitter and fiber density values are different for various muscles and age groups and the reference values increase with age. In this study, we evaluated the reference values of jitter and fiber density of frontalis muscle in healthy subjects older than 70 years. METHODS: We evaluated the jitter and fiber density of frontalis muscle in 32 healthy subjects. Twenty-two of them were between 70 and 79 years old (mean +/- SD, 73.9 +/- 1.7), and 10 of them were older than 80 years (mean +/- SD, 82.2 +/- 1.2). RESULTS: Normal limit of jitter (95% confidence limit) was calculated as 40.4 micros for healthy subjects between 70 and 79 years old and 43.7 micros for healthy subjects older than 80 years and normal limit of fiber density (95% confidence limit) were calculated as 1.90 for subjects between 70 and 79 years old and 2.14 for subjects older than 80 years. CONCLUSIONS: We designated the reference values of jitter and fiber density for frontalis muscle in healthy subjects older than 70 years. Our reference values may have value to diagnose neuromuscular transmission abnormalities in elderly patients. SIGNIFICANCE: SFEMG is sensitive for neuromuscular transmission abnormalities and it is important to know the reference values of frontalis muscle in healthy subjects older than 70 years.  相似文献   

14.
目的探讨单纤维肌电图(SFEMG)对糖尿病周围神经病变(DPN)的应用价值。方法应用SFEMG检测129例DPN患者的优势侧指总伸肌颤抖(jitter)和纤维密度(FD),按常规方法行神经传导速度(NCS)检测。比较SFEMG和NCS的异常检出率,并分析jitter值与血糖化血红蛋白(HbA1C)和预后的关系。结果 SFEMG异常检出率(91.5%)显著高于NCS(78.3%)(P<0.01)。HbA1C轻度升高组SFEMG异常检出率(86.4%)显著高于NCS异常检出率(69.7%)(χ2=7.69,P<0.01),而HbA1C重度升高组差异无统计学意义。jitter值与HbA1C水平呈正相关(r=0.3132,P<0.05)。jitter值正常及轻度异常患者治疗有效率(82.3%)及治愈率(30.6%)均显著高于明显异常者(54.2%,11.9%)(χ2=11.02,P<0.01;χ2=6.32,P<0.05)。结论 SFEMG对DPN的诊断意义显著,并且可用于DPN的预后判断。  相似文献   

15.
OBJECTIVE: To investigate the neuromuscular transmission (NMT) of the patients with transient global amnesia (TGA) using single fiber electromyography (SFEMG). BACKGROUND: The pathophysiology of TGA remains unknown and several elements support the hypothesis of a shared background with migraine. Recent studies showed that some migraineurs have subclinical abnormalities of NMT by using SFEMG. We aimed to test the patients with TGA using SFEMG. METHODS: We investigated 6 patients diagnosed with TGA according to published criteria and 5 healthy volunteers with similar ages. SFEMG during voluntary contraction of the extensor digitorum communis muscle, nerve conduction studies and concentric needle electromyography were performed and 20 single fiber potential pairs were recorded from each subject and individual and mean jitter values were calculated. RESULTS: Three patients with TGA showed pronounced NMT failure by SFEMG, whereas none of the controls disclosed this abnormality. The mean jitter value of TGA patients (35+/-33) was greater than that of the control subjects (25+/-15) (P=0.006). Seventeen of the 120 individual jitter values of the TGA group and only 3 (from 3 different volunteers) of the 100 individual jitter values of the control group exceeded upper normal limit (P=0.004). CONCLUSIONS: These results suggest that TGA shares the same type of subclinical abnormality of NMT observed in migraine patients in recent studies.  相似文献   

16.
Although persistently raised serum creatine kinase (sCK), or hyperCKemia, is considered the biological hallmark of neuromuscular diseases, pauci- or asymptomatic- or isolated-hyperCKemia can often be found. Single-fiber electromyography (SFEMG) is an electrophysiological technique of great value in the assessment of neuromuscular, neuropathic and myopathic disorders. We hypothesize that SFEMG fiber density (FD) evaluation is able to detect subclinical electrophysiological abnormalities indicating a myopathic process in subjects with hyperCKemia. Nineteen subjects with hyperCKemia without evident clinical signs of muscle involvement and 15 healthy controls were studied. Electrophysiological investigations including nerve conduction studies (NCS), quantitative EMG (QEMG), SFEMG with focus on FD measurements, and muscle biopsy were performed. NCS, QEMG, SFEMG were normal in all controls. In subjects with hyperCKemia, NCS were normal; QEMG was abnormal in 5, while both SFEMG and muscle biopsy disclosed abnormalities in 12 subjects. The mean FD value was 2.6 ± 0.5 in the control and 4 ± 1.4 (p = 0.003) in the hyperCKemia group. SFEMG revealed subclinical changes in the majority of subjects with hyperCKemia. To the best of our knowledge, this is the first study demonstrating that SFEMG FD evaluation is able to detect the presence of muscle diseases, which are in a subclinical phase and would remain unidentified otherwise. SFEMG may be used to distinguish hyperCKemia associated to asymptomatic muscle disorders from idiopathic hyperCKemia. We believe that SFEMG FD evaluation should be added to the routine examinations in the screening of idiopathic hyperCKemia.  相似文献   

17.
We studied neuromuscular transmission in 16 patients with prior poliomyelitis by measuring single fiber electromyographic (SFEMG) jitter. This was compared with 3 indirect methods of assessing reinnervation: SFEMG fiber density, macro EMG, and the presence of fiber type grouping on muscle biopsy. In patients with acute poliomyelitis before the age of 10, there was a positive correlation between the extent of neuromuscular transmission impairment, demonstrated by increased SFEMG jitter, and the enlargement of the motor unit, as indicated by increased fiber density, increased macro EMG signals, and fiber type grouping on muscle biopsy. However, there was no correlation between any of these parameters and the presence or absence of new symptoms of weakness. These findings suggest that impaired neuromuscular transmission is most common in patients with prior poliomyelitis whose motor units have been maximally enlarged by axonal sprouting, but is independent of the presence or absence of new symptoms of weakness.  相似文献   

18.
目的 探讨单纤维肌电图(SFEMG)技术在肌萎缩侧索硬化(ALS)与神经根型和脊髓型颈椎病鉴别诊断中的价值.方法 对61例ALS伴有MRI颈椎病表现、59例ALS不伴MRI颈椎病表现、55例神经根型和脊髓型颈椎病患者进行伸指总肌SFEMG测定,分析不同组之间SFEMG改变的特点.结果 在3组患者中,平均颤抖(jitter)值分别为(81.2±25.9)、(91.6±32.4)、(40.9±11.8) μs,jitter>55 μs的百分比M50分别为73%、80%、5%,阻滞所占百分比M50分别为10%、20%、0,纤维密度分别为2.9±0.5、2.9±0.6、2.4±0.6.ALS伴和不伴MRI颈椎病变2组之间各参数比较差异无统计学意义.两组ALS患者合并后[平均jitter值(86.3±29.6)μs,jitter>55μs的百分比M50为80%,阻滞所占百分比M50为14%,纤维密度2.9±0.5]再与颈椎病组比较,各参数均明显高于颈椎病组(分别为t=14.49,Z=8.96、7.68,t=5.83,均P=0.000).在经随诊而确诊的18例ALS患者中,初诊时肌电图仅有1个节段的神经源性损害,在伸指总肌肌力和常规肌电图均正常情况下,有16例SFEMG可见纤维密度增高,13例jitter增宽,6例可见阻滞.结论 ALS伴或不伴MRI颈椎病变的SFEMG均表现为jitter明显增宽,可伴有阻滞,纤维密度增高,与神经根型和(或)脊髓型颈椎病患者明显不同.SFEMG测定有助于ALS与颈椎病的鉴别诊断.  相似文献   

19.
We performed single fiber electromyography (SFEMG) in the superior rectus and levator palpebralis (SR-LP) muscles of 17 patients with pure ocular myasthenia gravis (MG) and 9 controls. Thirteen patients were also assessed with SFEMG in the orbicularis oculi (OO) muscle. All the MG patients but none of the control subjects showed abnormal SFEMG jitter in the SR-LP muscles. On the other hand, only 62% of the MG patients had abnormal SFEMG jitter in the OO muscle. The procedure was well tolerated by the patients, and complications were minor. We conclude that SFEMG of the SR–LP muscles is a safe and highly sensitive technique for the diagnosis of ocular MG. © 1995 John Wiley & Sons, Inc.  相似文献   

20.
目的 探讨单纤维肌电图(SFEMG)技术在肌萎缩侧索硬化(ALS)鉴别诊断中的价值.方法 对我院收治的165例ALS患者和145例下运动神经元受累为主的非ALS疾病患者进行伸指总肌SFEMG测定,并测定伸指总肌肌力,按照伸指总肌肌力进行分组,分析不同组之间SFEMG改变的特点.结果 伸指总肌肌力正常者,ALS和非ALS组的平均颤抖(jitter)值分别为(66.1±20.1)、(38.0±9.2)μs(t=9.05),jitter>55μs的百分比中位数分别为55%、0(Z=-7.81),阻滞所占百分比中位数分别为6.7%、0(Z=-6.93),ALS组各参数均明显高于非ALS组(均P<0.01).伸指总肌肌力医学研究委员会(MRC)评分≤4者,ALS和非ALS组平均jitter值分别为(93.5±31.2)、(52.8±25.9)μs(t=9.37),jitter>55μs的百分比中位数分别为86%、20%(Z=-8.46),阻滞所占百分比中位数分别为20%、0(Z=-7.25),ALS组各参数均明显高于非ALS组(均P<0.01).在MRC评分>4者,采用平均jitter>55μ s诊断ALS的敏感性和特异性分别为70.2%和92.7%.结论 当采用SFEMG测定协助ALS的诊断和鉴别时,应尽量选择肌力正常的肌肉.平均jitter、jitter>55μs的百分比和阻滞在ALS与其他下运动神经元疾病的鉴别诊断中具有重要价值.  相似文献   

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