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卒中后肩痛周围神经电生理学研究
引用本文:王青青,李铁山,阎文静,王琳,高正玉.卒中后肩痛周围神经电生理学研究[J].中国卒中杂志,2012,7(4):278-283.
作者姓名:王青青  李铁山  阎文静  王琳  高正玉
作者单位:1.青岛大学2青岛大学医学院附属医院康复医学科
摘    要:目的 通过对卒中后肩痛患者上肢进行神经传导速度检查及针极肌电图检查,观察卒中后肩痛患者周围神经电生理指标的变化。方法 选择符合入选标准的卒中住院患者40例,根据数字疼痛评分法(Numerical Pain Rating Scale,NPRS)分为肩痛组(26例)与无肩痛组(14例)。分别进行双侧上肢神经传导速度检查和针极肌电图(electromyography,EMG)检查。结果 肩痛组患侧腋神经、肌皮神经、正中神经复合肌肉动作电位(compound muscle action potential,CMAP)波幅较无肩痛组患侧降低,差异有显著性(P=0.000,0.001,0.000);无肩痛组患侧尺神经CMAP波幅较同组健侧降低,差异有显著性(P=0.000);肩痛组患侧尺神经感觉神经动作电位(sensory nerve action potential,SNAP)波幅较无肩痛组患侧降低,差异有显著性(P=0.000)。三角肌、肱二头肌自发电位出现率,肩痛组较无肩痛组增高,差异具有显著性(P=0.044,0.044)。结论 卒中后肩痛患者伴有上肢周围神经的损伤,且肩痛的发生可能与运动神经损伤有关。

关 键 词:卒中  肩痛  周围神经  电生理学  
收稿时间:2011-12-10

Peripheral Nerve Eleetrophysiologieal Studies of Post Stroke Shoulder Pain
WANG Qing-Qing,LI Tie-Shan,YAN Wen-Jing,WANG Lin,GAO Zheng-Yu.Peripheral Nerve Eleetrophysiologieal Studies of Post Stroke Shoulder Pain[J].Chinese Journal of Stroke,2012,7(4):278-283.
Authors:WANG Qing-Qing  LI Tie-Shan  YAN Wen-Jing  WANG Lin  GAO Zheng-Yu
Institution:. (Department of Rehabilitation, the Affiliated Hospital of Medical College Qingdao University, Qingdao 266003, China)
Abstract:Objective To analyze the electrophysiological features of peripheral nerve in upper extremity of post stroke shoulder pain. Methods Forty stroke patients were divided into shoulder-pain group(26 patients) and without shoulder-pain group(14 patients). Standard motor and sensory nerve conduction studies were performed with 40 stroke patients, including nerve conduction velocity and needle electromyography(EMG). Results The motor nerve conduction velocity in axillaris nerve, musculocutaneous nerve, medianus nerve of shoulder-pain group were evaluated, we found that the compound muscle action potential(CMAP) amplitudes were significantly decreased compared with the without shoulder-pain group(P=0.000, 0.001, 0.000). The CMAP amplitude of ulnaris nerve was significantly lower on the affected side than that on the unaffected side in without shoulder- pain group(P=0.000). The sensory nerve action potential(SNAP) amplitude of ulnaris nerve was significantly smaller on the hemiplegic side in shoulder-pain group than that in without shoulder-pain group(P=0.000). The incidence of spontaneous electrical potential of the deltoid and biceps in shoulder-pain group were significantly higher than those in without shoulder-pain group(P=0.044, 0.044). Conclusion Peripheral nerve damage was found in post stroke shoulder pain, injury to motor neuro may be important for development of neuropathic pain.
Keywords:Stroke  Shoulder-pain  Peripheral nerve  Electrophysiology
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