肌萎缩侧索硬化症152例下胸段脊旁肌肌电图特点

目的探讨下胸段脊旁肌肌电图在肌萎缩侧索硬化症(ALS)诊断中的应用价值。方法总结152例确诊ALS患者的临床及电生理资料,观察下胸段脊旁肌肌电图的特点,并分析其与病程、年龄、首发部位、呼吸困难、胸锁乳突肌肌电图、舌肌肌电图的相关性。结果152例ALS中,下胸段脊旁肌肌电图出现自发电位者125例(82．24%)；胸锁乳突肌肌电图呈神经源性损害83例(55．33%),其中出现自发电位者45例。通过Logistic多元回归分析提示脊旁肌肌电图与病程、年龄有关,而与首发部位、呼吸困难无明显相关性。结论脊旁肌肌电图与ALS患者的病程及年龄有关,且下胸段脊旁肌肌电图方便易行,在ALS中诊断价值较大。

Electromyographic features of lower thoracic paraspinal muscle in diagnosis of amyotrophic lateral sclerosis

Objective To investigate the value of electromyogram of lower thoracic paraspinal muscle in diagnosis of amyotrophic lateral sclerosis (ALS).Methods The clinical and electrophysiological data of 152 ALS cases were collected.The denervation potentials (fibrillation potentials and positive sharp waves) of lower thoracic paraspinal muscle were analyzed.The relations of electrophysiological changes of lower thoracic paraspinal muscle with disease duration,location of onset, dyspnea,electrophysiological changes of stemocleidomastoid and tongue muscles were studied.Results Denervation potentials were found in thoracic paraspinal muscles in 125 of 152 ALS patients(82.2%).And chronic neurogenic changes in sternocleidomastoid muscle were detected in 83 of 152 cases (55.33%). Fibrillation potential or positive sharp waves in sternocleidomastoid muscle were found in 45 of 152 cases. Denervation potentials in tongue muscle were found in 31 of 64 cases.Logistic multiple regression analysis revealed the relation of the electrophysiological changes of thoracic paraspinal muscle with disease duration, age,but not with the location of onset and dyspnea.Conclusion Electromyography of lower thoracic paraspinal muscles,related to the disease duration and age of patients,is of great value in the diagnosis of ALS.