摘要
目的探讨肛门括约肌肌电图(EAS-EMG)在诊断帕金森病(PD)和多系统萎缩(MSA)中的作用。方法对临床诊断的51例PD患者和42例MSA患者(拟诊MSA33例、可能MSA9例)进行EAS-EMG检查和自主神经功能障碍的临床特点分析,并评价EAS-EMG在MSA与PD鉴别中的判对率。结果MSA患者的自发电位出现率(78.6%)、运动单位动作电位(MUP)平均时限[(8.1±2.5)ms]和募集电位单纯相出现率(40.0%)均显著高于PD患者[29.4%、(6.9±1.2)ms和12.2%,P值分别<0.01、0.05]。在MSA患者中,自主神经功能障碍累及范围越广,EAS-EMG自发电位出现率越高(Rs=0.505,P=0.001)。以自发电位出现率和MUP平均时限为主要鉴别指标,EAS-EMG对PD和MSA预测的总体判对率为76.3%。结论EAS-EMG检查结果可作为鉴别MSA与PD的重要参考依据;MSA患者EAS-EMG检查异常与自主神经功能障碍存在一定的相关性。
Objective To assess the value of external anal sphincter electromyography （EAS-EMG） in the differential diagnosis of Parkinson＇s disease （PD） and multiple system atrophy （MSA）. Methods EAS-EMG was performed in 51 patients with PD and 42 patients who were diagnosed as having probably MSA （n=42） and possible MSA （n= 9）. The clinical features of autonomic nervous dysfunction were also recorded. The performance of EAS-EMG differential diagnosis between MSA and PD was evaluated. Results The occurance of spontaneous potential, duration of mean motor unit potential （MUP） and occurance of simple phase in recruited activity were higher in MSA patients compared to PD patients （78.6% vs. 29.4%, [8.1±2.51 ms vs. [6.9±1.21 ms, 40.0% vs. 12.2%, all P〈0.05）. Meanwhile, the greater the involvement of autonomic nervous system dysfunction was,the higher the incidence of spontaneous activity of EAS-EMG were in MSA patients （Rs = 0. 505, P = 0.001）. The overall correct predicting rate of EAS-EMG for PD and MSA was 76.3 % when occurance of spontaneous activity and MUP duration were used for the Logistic regression classification model. Conclusion EAS-EMG testing may serve as an important evidence for distinguishing MSA from PD, the EAS-EMG abnormalities in MSA patients tends to be related to autonomic nervous dysfunction.
出处
《上海医学》
CAS
CSCD
北大核心
2009年第8期715-719,共5页
Shanghai Medical Journal
关键词
肛门括约肌肌电图
帕金森病
多系统萎缩
自主神经功能障碍
判对率
External anal sphincter electromyography
Parkinson＇s disease
Multiple system atrophy
Autonomic nervous dysfunction
Predict correct percentage
