肯定型肌萎缩性侧索硬化症的运动神经传导速度和F波改变特点及其影响因素

目的 观察肯定型肌萎缩性侧索硬化症(definite amyotrophic lateral sclerosis，DALS)的运动神经传导速度(motor neuron conduction velocity，MCV)和F波改变特点，以及病情和病程对MCV和F波的影响。方法 对46例肯定型ALS患者和正常对照组的：MCV和F波进行测定。结果 患者组正中神经、尺神经、胫神经和腓深神经的末端运动潜伏期(distal motor latency，DML)明显延长。F波的出现率、近端段／中枢潜伏期和左右往返脊髓的近端段／中枢潜伏期的差值与对照组比较差异均有显著性意义。患者重度组4条神经的DML显著延长，MCV明显减慢和波幅明显降低，重度组正中神经和尺神经的DML、MCV和波幅与轻度组比较差异也有显著性意义。随访患者组3年，其运动神经传导速度和F波检查结果经配对方差检验，差异均有显著性意义。结论 MCV和F波可作为ALS电生理诊断的一项有价值的检查,其异常程度与病情和病程有关。

Characteristics of the motor nerve conduction and F wave in patients with definite amyotrophic lateral sclerosis

Objective To characterize the changes of motor nerve conduction velocity (MCV) and F wave in patients with definite amyotrophic lateral sclerosis (DALS) as related to the duration and severity of the disease. Methods A total of 46 patients with DALS were recruited for the ALS group and 35 healthy adults for the control group. MCV and F wave were examined with median, ulnar, tibial and peroneal nerves in all the patients and compared with those in the controls. Results It was found that the distal motor latencies (DML) and MCV of the median, ulnar, tibial and peroneal profundus nerves in the ALS group were all significantly delayed as compared to those in the control group. The F wave occurrence frequency was lower, the central latencies as well as its side-to-side difference of the F wave in the 4 nerves were significantly longer in the ALS group than those in the control group. For those with more severe conditions, their central latencies of F wave and DML in the 4 nerves of ALS patients were significantly longer, and the MCV were significantly slower than those with milder conditions. A 3-year of follow-up of the patient revealed that there were progressive delay in DML and F wave central latencies, as well as a progressive decrease in MCV or CAMP amplitude. Conclusion The duration and severity of ALS has significant effects on the MCV and F wave of nerves in the upper and lower limbs. MCV and F wave can be used as valuable electrodiagnostic tools for DALS.