论文部分内容阅读
目的探讨痉挛型脑性瘫痪(脑瘫)患儿下肢H反射变化及其评价肢体痉挛的可靠性,探讨痉挛型高肌张力定量评估的客观指标。方法选取本院2010年1月-2011年12月神经康复科收治的50例痉挛型脑瘫患儿为脑瘫组。男33例,女17例。另选取20例健康儿童作为健康对照组。男11例,女9例。应用美国Nicolet公司生产的VikingⅣD型肌电图仪进行H反射测定,对脑瘫组和健康对照组儿童H反射潜伏期、波幅及最大H波与最大M波百分比(Hmax/Mmax,H/M)进行比较。对脑瘫组患儿痉挛侧下肢进行改良综合痉挛量表(CSS)评分,并与H波幅、H/M值进行相关性分析。结果脑瘫组患儿H反射潜伏期为(18.87±2.94)ms,H波幅为(4.21±2.85)μV,H/M值为35.24±16.32;健康对照组儿童H反射潜伏期为(23.20±1.98)ms,H波幅为(2.34±1.53)μV,H/M值为14.23±6.36。脑瘫组患儿H波潜伏期缩短,H波幅增大,H/M值增高,与健康对照组比较差异均有统计学意义(Pa<0.05)。脑瘫组患儿下肢CSS评分为(7.75±2.27)分,与H波幅呈正相关(r=0.562,P<0.05),与H/M值亦呈显著正相关(r=0.904,P<0.01),其线性方程为Y=8.425X-30.021。结论 H反射可作为痉挛型脑瘫患儿痉挛下肢运动神经元兴奋性的量化指标。
Objective To investigate the change of lower limb H reflex in children with spastic cerebral palsy (cerebral palsy) and to evaluate the reliability of limb spasm and to explore the objective indexes of quantitative assessment of spastic hypertrophic muscle tension. Methods Fifty children with spastic cerebral palsy admitted to Department of Neurology and Rehabilitation from January 2010 to December 2011 were selected as cerebral palsy group. There were 33 males and 17 females. Another 20 healthy children as healthy control group. There were 11 males and 9 females. Hick’s reflexes were measured by VikingⅣD electromyography instrument manufactured by Nicolet Inc. in America. H-reflex latency, amplitude, maximum H wave and maximum M wave percentage (H / Mmax, H / M) were compared between children with cerebral palsy and healthy controls . The patients with cerebral palsy group spastic lateral leg improved comprehensive spasticity scale (CSS) score, and H amplitude, H / M value correlation analysis. Results The latent period of H reflex in children with cerebral palsy was (18.87 ± 2.94) ms, the amplitude of H was (4.21 ± 2.85) μV and the value of H / M was 35.24 ± 16.32. The latent period of H reflex in children with cerebral palsy was (23.20 ± 1.98) H amplitude was (2.34 ± 1.53) μV, H / M value was 14.23 ± 6.36. The H wave latency, H amplitude and H / M value of children with cerebral palsy group were shorter than those of healthy control group (P <0.05). The CSS score of lower extremity in cerebral palsy group was (7.75 ± 2.27) points, positively correlated with the amplitude of H (r = 0.562, P <0.05) and positively correlated with H / M value The linear equation is Y = 8.425X-30.021. Conclusions H reflex can be used as a quantitative index of motor neuron excitability of spastic lower extremities in children with spastic cerebral palsy.