摘要
目的研究脑卒中偏瘫患者周围神经的神经电生理变化。方法选择南昌大学第三附属医院脑卒中偏瘫患者180例,3～7 d、6个月进行肢体神经传导、针极肌电图、交感神经皮肤反应(SSR)测定。结果 180例患脑卒中偏瘫患者急性期1例检测出双侧腓肠神经传导速度减慢,针极肌电图正常;病程6个月时,56例出现NCV异常,运动神经总异常率为3.6%,感觉神经总异常率6.4%,SCV异常率高于MCV异常率。肌电图:①患侧:21例出现插入电位延长,18例有自发电位;②健侧:4例出现插入电位及自发电位。SSR:脑卒中偏瘫患者急性期、病程6个月时,健侧、患侧SSR潜伏期、波幅与正常值比较差异有统计学意义(P<0.05),而健侧潜伏期、波幅及患侧潜伏期、波幅比较差异无统计学意义(P>0.05)。6个月与急性期对比,患侧及健侧下肢、健侧上肢潜伏期差异有统计学意义(P<0.01),患侧上肢潜伏期及所有肢体波幅差异无统计学意义(P>0.05)。结论脑卒中偏瘫患者在病程6个月出现周围神经损害,SCV异常率高于MCV异常率,而在急性期出现SSR抑制、自主神经功能异常。
Objective To study the neuroelectrophysiological changes of peripheral nerve in stroke patients with hemiplegia.Methods 180 patients with hemiplegia due to stroke in the Third Affiliated Hospital of Nanchang University were selected for the measurement of limb nerve conduction,needle electromyogram and sympathetic skin reaction(SSR)at the course of disease of 3-7 days and 6 months.Results In the acute phase of 180 stroke patients with hemiplegia,1 patient was found to have bilateral slow peroneal nerve conduction,the needle electromyogram was normal,and the course was 6 months.There were 56 cases with NCV abnormality,the total motor nerve abnormality rate was 3.6%,the total sensory nerve abnormality rate was 6.4%,and the SCV abnormality rate was higher than the MCV abnormality rate.Electromyogram:the affected side:21 cases had extension of insertion potential and 18 cases had spontaneous potential.Healthy side:4 cases had insertion potential and spontaneous potential.SSR:when the acute stage and course of stroke patients with hemiplegia were 6 months,the differences of SSR latency,amplitude and normal values between the healthy side and the affected side were statistically significant(P<0.05),while the differences of the latent period,amplitude,and latency and amplitude of the affected side were not statistically significant(P>0.05).Compared with the acute stage at 6 months,the difference in the incubation period of the healthy lower limb and the healthy upper limb was statistically significant(P<0.01),while the difference in the incubation period of the infected upper limb and the amplitude of all limbs was not statistically significant(P>0.05).Conclusion Peripheral nerve damage occurres in stroke patients with hemiplegia at 6 months of course,and the abnormal rate of SCV is higher than the abnormal rate of MCV,while SSR inhibition and autonomic nerve dysfunction occurres in acute phase.
作者
陈小红
周凤
樊海风
杨得奖
李新明
CHEN Xiaohong;ZHOU Feng;FAN Haifeng;YANG Dejiang;LI Xinming(Department of Neurology,the Third Affiliated Hospital of Nanchang University,Nanchang 330006,China)
出处
《中国实用神经疾病杂志》
2019年第2期154-158,共5页
Chinese Journal of Practical Nervous Diseases
关键词
脑卒中
偏瘫
神经电生理
周围神经
神经传导
针极肌电图
交感神经皮肤反应
Stroke
Hemiplegia
Neuroelectrophysiology
Peripheral nerves
Nerve conduction
Needle electromyogram
Sympathetic skin response(SSR)
