论文部分内容阅读
目的通过对临床诊断的脑卒中后肩手综合征(shouder-hand syndrome,SHS)患者神经电生理指标的分析,明确并初步探讨周围神经损伤在SHS发生发展机制中的作用。方法将58例脑卒中患者分为SHS组(39例,伴SHS)和对照组(19例,不伴SHS),分别进行正中神经的针极肌电图(EMG)和神经传导测定。结果针极肌电图检查SHS组39例(100%)均检出插入电位异常,测得纤颤电位和正锐波,异常率明显高于对照组(P＜0．01)。SHS组感觉神经动作电位波幅为(7．77±4．34)mV,复合肌肉动作电位波幅为(10．13±3．15)mV,均较对照组明显降低(P＜0．05),且感觉神经波幅下降程度较运动神经明显(P＜0．05)。结论电生理检查证实SHS的病理生理改变中有周围神经损害因素参与,周围神经损害以轴索变性为主,且感觉神经受累程度重于运动神经。
OBJECTIVE: To determine the role of peripheral nerve injury in the development and progression of SHS by analyzing the electrophysiological indexes of patients with clinically diagnosed stroke-hand syndrome (SHS). Methods Fifty-eight stroke patients were divided into three groups: SHS group (39 cases with SHS) and control group (19 cases without SHS). Electrocardiogram (EMG) and nerve conduction were measured respectively. Results In the 39 cases (100%) of SHS group, the anomalies of intercalation potentials were detected and the fibrillation potentials and positive sharp waves were measured. The abnormal rates were significantly higher than those of the control group (P <0.01). The amplitude of sensory nerve action potential in SHS group was (7.77 ± 4.34) mV and the amplitude of combined muscle action potential was (10.13 ± 3.15) mV, which were significantly lower than those in control group (P <0.05) And the sensory nerve amplitude decreased more significantly than motor nerve (P <0.05). Conclusion Electrophysiological examination confirmed the involvement of peripheral nerve damage factors in the pathophysiological changes of SHS. Axonal degeneration was predominant in peripheral nerve damage, and sensory nerve involvement was more severe than motor nerve.