摘要
目的回顾性研究脊髓亚急性联合变性(SCD)患者临床神经损害相关因素及神经电生理相关特点。方法选取2013年1月至2015年7月就诊于中国医科大学附属第一医院神经内科既往未进行治疗,最终确诊为SCD的患者(29例)作为研究对象,分析其神经损害程度与病程、血清VB12水平之间的相关性;总结分析其临床及电生理资料。结果患者病程(8.11±11.65)个月,与SCD神经损害程度显著相关(P=0.001);血清VB12(62.69±44.84)pmol/L,与神经损害程度无显著相关(P>0.05)。电生理资料显示,共检测神经256条,运动神经异常率(15.20%)低于感觉神经(42.75%),差异有统计学意义(P<0.001);上肢神经异常率(27.10%)低于下肢神经(30.87%),但差异没有统计学意义(P=0.578);运动神经中各神经(尺神经、正中神经、胫神经、腓总神经)损害异常率无统计学差异(P=0.320),感觉神经中各神经(尺神经、正中神经、胫神经、腓肠神经、腓浅神经)损害异常率无统计学差异(P=0.755);在肌电图记录的各个参数分析中,运动神经中各神经在复合肌肉动作电位波幅(CAMP)参数上损害异常比较差异有统计学意义(P=0.005);感觉神经中各神经在CAMP、未引出参数上损害异常比较差异有统计学意义(均P<0.001)。结论 SCD神经损害程度与病程长短存在显著相关性;感觉神经较运动神经更易受累;运动神经中腓总神经在CAMP上较其他神经更易受累;感觉神经中胫神经在CAMP上较其他神经更易受累,且胫神经整体受累程度较重。
Objective To retrospectively study the clinical and electrodiagnostic features in subacute combined degeneration of spinal cord（SCD）patients. Methods The clinical and electrodiagnostic recordings of all SCD patients conformed in our Neurology Department from January 2013 to July 2015 were retrospectively reviewed. Totally 29 patients diagnosed as SCD,whom received no treatment before admitted in our hospital,were recruited for the study. Correlation analysis between serum level of vitamin B12（VB12）,course of disease and degree of neural lesion was performed,and the electrodiagnostic features were summarized and analyzed. Results The course of disease had significant correlation with the degree of neural lesion（P = 0.001）,but there was no significant relevance between serum VB12 level and neural damage（P〉0.05）. Electrodiagnostic examination revealed：The abnormal rate of motor nerve（15.20%）was lower than that of sensory nerve（42.75%,P〈0.001）and the upper limb nerve（27.1%）was lower than that of lower limb nerve（30.87%,P = 0.578）. There was no remarkable difference of abnormal rate in all kinds of nerves of motor and sensory nerve（P1=0.320,P2=0.755）. In the analysis of the parameters of electromyograph,there was statistical significance of the abnormal rates of compound muscle action potential（CAMP）between each motor nerve（P = 0.005）. There was statistical significance of the abnormal rates of CAMP and no function between each sensory nerve（all P〈0.001）. Conclusion The course of disease has significant correlation with the degree of neural lesion. Sensory nerve is tended to be betreffend than motor nerve. Phil.always nervous are more likely to be affected than others in motor nerve at CAMP. Tibial nerve is easier to be influenced at CAMP in sensory nerve,and the lesion is more serious.
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2016年第8期715-718,共4页
Journal of China Medical University
基金
辽宁省自然科学基金(201202276)
关键词
脊髓亚急性联合变性
维生素B12
神经损害
电生理学
subacute combined degeneration of spinal cord
vitamin B12
neural lesion
electrophysiology
