摘要
目的研究磁刺激运动诱发电位(motorevokedpotentials,MEP)对脊髓损伤(spinalcordinjuries,SCI)后运动传导功能的诊断价值。方法采用Mag -2型磁刺激仪对32例SCI患者进行经颅磁刺激MEP检查 ,分别在双侧外展拇短肌(abductorpollicisbrevis ,APB)和胫前肌(anteriortibialis ,AT)进行记录。同时检测F波和M波计算中枢运动传导时间(centralmotorconductivetime,CMCT)。另采用Keypoint肌电图仪进行体感诱发电位(somatosensoryevokedpotentials,SEP)检查以作对比。收集患者的临床资料并按照ASIA92运动评分和损伤标准分级。结果SCI患者APB肌MEP潜伏期为 (28.88±13.85)ms ,波幅为 (0.32±0.34)mV;AT肌潜伏期为 (42.60±16.07)ms ,波幅为 (0.40±0.73)mV ,与正常对照组相比差异有显著性意义(P<0.05)。其中完全性瘫痪者无MEP信号 ,不完全性瘫痪者MEP潜伏期延迟 ,波幅下降。MEP潜伏期延迟时间与ASIA运动评分呈负相关(P<0.01)。多数SCI患者上肢或下肢SEP消失或潜伏期延迟 ,但与MEP结果不一致 ,并且与ASIA运动功能评分无相关性。结论SCI后损伤平面以下的肌力大小与MEP异常表现密切相关。MEP检查为判断脊髓运动传导束功能状态提供了客观、定量的依据 ;
Objective To study the diagnostic value of the magnetic stimulation motor evoked potentials (MEP) and somatosensory evoked potentials (SEP) in neurologic function after spinal cord injuries (SCI), especially the motor conductive function. Methods Thirty-two cases of SCI patients received MEP examination elicited with a Mag-2 magnetic stimulator. MEP were recorded bilaterally at abductor pollicis brevis(APB) and anterior tibialis (AT)muscles. F waves and M waves were also recorded to calculated the central motor conductive time (CMCT). SEP examination was performed with a Keypoint electromyograph. The clinical status of the patients was divided by the ASIA 92 principles. Results In SCI group, the latency and amplitude of the APB MEP were (28.88±13.85) ms and (0.32±0.34)mV respectively, the latency and amplitude of the AT muscles MEP were (42.60±16.07)ms and (0.40±0.73)mV respectively. All of them were significantly different from the results of control group (P< 0.05). Among them the complete paralysis cases had no MEP signals, while the MEP in incomplete injured group had decreased amplitude and increased latency. There was significant correlation between the MEP latency and the ASIA motor scores (P< 0.05). The SEP signals of most SCI cases obliterated or delayed,which had no correlation with the results of MEP examination or ASIA motor scores. Conclusion The muscle strength under the injured level is intensively correlated with the MEP abnormal. MEP examination can provide an objective and quantitative standard for judging the motor functional status in the cord, while the SEP examination can not reflect the severity of motor lesion.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2000年第5期269-274,共6页
Chinese Journal of Orthopaedics
基金
上海市医学领先专业重点学科基金资助!(1995-Ⅳ-008)
关键词
脊髓损伤
体感诱发电位
磁刺激运动诱发电位
Spinal cord injuries
Evoked potentials,somatosensory
Evoked potentials,motor
Motor activity
