胸段脊旁肌肌电图在肌萎缩侧索硬化诊断中的作用

目的 研究胸段脊旁肌自发电位在诊断肌萎缩侧索硬化(amyotrophic lateral sclerosis，ALS)中的价值。方法 50例确诊的ALS患者分别行胸段脊旁肌自发电位、胸锁乳突肌运动单位，部分患者行舌肌自发电位检测；同时，将性别、年龄相匹配的30例根性损害的患者和30名健康人作为对照，行胸段脊旁肌自发电位检测。结果 50例ALS患者中，41例(82％)胸段脊旁肌肌电图可见大量纤颤电位和正锐波；胸锁乳突肌肌电图无一例见自发电位，但有48例(96%)运动单位时限增宽，波幅增高，符合慢性神经源性损害改变；6例患者行舌肌自发电位检测，3例可见自发电位。30例根性病变的患者中，2例(7％)可见胸段脊旁肌有少量自发电位；健康对照组未见胸段脊旁肌自发电位。结论 胸段脊旁肌大量自发电位对诊断ALS具有一定的敏感性。

Assessment of thoracic paraspinal muscles with electromyography in the diagnosis of ALS

Objective To evaluate denervation changes fibrillation potentials (fib) and positive sharp waves (psw)] in thoracic paraspinal muscles as diagnostic aids in amyotrophic lateral sclerosis (ALS). Methods The fib and psw of thoracic paraspinal muscles,the motor unit potential of sternocleidomastoid muscle were detected in 50 patients who had been identified as having ALS.Age and sex-matched,30 normal subjects and 30 patients who suffered radicular disease in cervical or lumbosacral region were also detected in thoracic paraspinal muscles for finding fib and psw serving as controls. Results In ALS group,a vast of fib and psw were found in thoracic paraspinal muscles in 41 of 50 ALS patients (82%),they were not found with sternocleidomastoid muscle,but the motor unit potential of this muscle was shown having long-duration and high-amplitude in 48 of 50 ALS patients (96%),which were coincided with the chronic neurogenic changes.6 of 50 patients had denervation changes of tongue muscles,3 of them found fib and psw.2 of 30 patients who suffered from radicular diseases were found with a few of fib and psw changes in thoracic paraspinal muscles.None of these symptoms were found in normal subjects.Conclusion A vast of fib and psw in thoracic paraspinal muscles should represent a sensitive tool for diagnosis of ALS.