颈胸髓损伤患者H反射测定值与痉挛的关系研究

目的探讨完全性颈胸髓损伤后H反射相关值的变化及其定量评价痉挛的程度。方法对13例健康成人(对照组)和30例脊髓损伤患者(亚急性期18例，慢性期12例)进行两次比目鱼肌H反射测定，两次之间相隔1个月，对患者同时运用改良Ashworth肌张力评定分级进行痉挛评估。结果通过比目鱼肌H反射检测，各阶段脊髓损伤患者H_max/M_max比、最大H波波幅无显著性差异(P>0.05)，但波幅均较健康成人明显减小(P<0.01)。脊髓损伤亚急性期痉挛程度与最大H波波幅、H_max/M_max比均呈quadratic关系(P<0.05)，慢性期后两者间呈线性关系(P<0.05)。结论脊髓损伤后比目鱼肌H_max/M_max比与痉挛有密切的关系，但它们之间的定量关系还需要更大样本来证实。

Relation between H Reflex and Spasticity after Cervical or Thoracic Spinal Cord Injury

ObjectiveTo investigate the changes and relevance of H reflex and spasticity after cervical or thoracic spinal cord injury (SCI).MethodsH reflex of 13 healthy adults as controls and 30 SCI patients (subacute, n=18; chronic, n=12) was measured twice from soleus muscle once a month. In the same time, the evaluation of spasm was performed by the modified Ashworth scale.ResultsThere was no significant difference in the mean H_max amplitude and H_max/M_max ratio between different SCI stages(P>0.05). However, the mean H_max amplitude of the patients was smaller than that of controls(P<0.01). During subacute stage there was quadratic correlation between the mean H_max amplitude and spasticity, H_max/M_max ratio and spasticity. But there was linear correlation between H_max/M_max ratio and spasticity during chronic stage.ConclusionThere was closer relation between spasticity and Hmax/Mmax ratio after spinal cord injury. However, the quantitative evaluation need to be proved by larger samples.