肌电图肌源性损害合并神经源性损害71例临床分析

目的分析和探讨肌电图(EMG)肌源性损害合并神经源性损害的临床和电生理特点。方法检索作者医院EMG数据库,收集EMG表现为肌源性损害合并神经源性损害患者共71例,对其临床和电生理特点进行回顾性分析。结果在此组患者中,最常见的是结缔组织病,共63例(占88.7%)。其余依次为:肿瘤、进行性肌营养不良、AIDS、甲状腺功能亢进(甲亢)。在全部患者中,临床表现为近端无力者55例(占77.5%),有感觉症状体征者27例(占38.0%),肌肉萎缩者12例(占16.9%)。患者的三角肌52例(占73.2%)、股四头肌49例(占69.0%)EMG表现为肌源性损害,其中上下肢同时为肌源性损害者32例(占45.1%)。所合并存在的神经源性损害主要表现为多发性周围神经病(39例)、单神经病(27例)、颈或腰骶神经根病(5例)。结论EMG检查有助于检出临床下神经肌肉病变,电生理检查发现肌源性合并神经源性损害的同时分析肌病所合并周围神经病变类型将有助于揭示病变性质。

The Clinical Features of 71 Patients with Myogenic and Neurogenic Lesions in Electrophysiologic Study

Objective To study and discuss the clinical and electrophysiologic feature of myogenic lesion accompanied with neurogenic lesion in 71 patients.Methods Retrospectively analyzing the clinical and electrophysiologic feature of these patients from our searching database of EMG and collected date of the patients.Results In the present study,we revealed the most common disease was connective tissue disease,accounting for 63 cases(88.7%);the others followed by : cancer,muscular dystrophy,inflammation of HIV,hyperthyroidism.55 cases(77.5%)had proximal extremities weakness,27 cases(38.0%) had dysfunction of sensation,12 cases(16.9%) had amyotrophy.52 cases(73.2%) showed myogenic lesion in deltoid muscles and 49 cases(69.0%) in quadriceps muscle of thigh,32 cases(45.1%) showed myogenic lesion in the upper and lower limbs at the same time.The type of neurogenic lesion including:multiple peripheral neuropathy(39 cases),mononeuropathy(27 cases),cervical and lumbar radiculopathy(5 cases).Conclusions The study of electrophysiology with EMG is useful for revealing subclinical lesion,and can supply the niveau diagnosis.In addition,It is important that EMG may provide etsologic evidence for different types of peripharal neurpathies in the diagnosis even encephal-myelo-neuropathies.