摘要
目的探索建立健康人周围神经刺激阈值的正常值范围,初步探讨年龄、性别对周围神经刺激阈值的影响。方法选取符合纳入标准的健康志愿者120例,其中男性58例,女性62例;年龄20~79岁,平均年龄49.3岁。采用Keypoint workstation肌电图及诱发电位仪,带通20 Hz^10 kHz(运动传导检测)或1 Hz^2 kHz(感觉传导检测),扫描速度每格5 ms,灵敏度每格5 mV(运动传导检测)或每格20μV(感觉传导检测),刺激频率1 Hz,刺激时限0.2 ms。检查时室温27℃~30℃,保证健康志愿者皮肤温度在30℃以上。在神经传导检测的基础上采用双向测量法分别对正中神经、尺神经、腓神经及腓浅神经感觉支进行检测,得到各神经不同年龄组的神经刺激阈值,并对结果进行统计学分析。结果将健康志愿者按照年龄分为6组,即20~29岁组(A组)、30~39岁组(B组)、40~49岁组(C组)、50~59岁组(D组)、60~69岁组(E组)、≥70岁组(F组),每组20例。采用单因素方差分析,正中神经与尺神经刺激阈值F组与A组、B组、C组间差异有统计学意义;腓神经和腓浅神经感觉支刺激阈值F组与A组、B组间差异有统计学意义;其余各组间差异无统计学意义。正中神经、尺神经、腓神经及腓浅神经感觉支神经刺激阈值随年龄增长有逐渐增大趋势,尤其高龄组(≥70岁),其神经刺激阈值明显高于低龄组(20~40岁组)。不同性别间同名神经刺激阈值差异无统计学意义。上下肢比较发现,下肢神经刺激阈值明显高于上肢。结论采用双向测量法检测周围神经刺激阈值是可行的;年龄对神经刺激阈值的影响虽然微小但的确存在,尤其对于老年人;性别对于神经刺激阈值没有显著影响,这一点尚需深入研究进一步明确;上下肢神经刺激阈值的差异可能与其生理功能差异、神经纤维长度有关。
Objective To establish normal range of neural threshold in healthy peripheral nerves, and evaluate the effects of age and gender on neural threshold. Methods A total of 120 healthy volunteers were enrolled, which included 58 males and 62 females, aged 20 - 79 years old with mean age of 49.3 years old. The Keypoint workstation EMG and evoked potential meter were used in band pass 20 Hz - 10 kHz（motion conduction detection） or 1 Hz - 2 kHz（sensory conduction detection）, scanning speed of 5 ms and sensitivity of 5 mV（motion conduction detection） or 20 pN（sensory conduction test）, stimulus frequency of 1 Hz and stimulation time of 0.2 ms. The room temperature was set at 27 ℃ - 30 ℃ to ensure skin temperature of healthy volunteers above 30 ℃. On basis of nerve conduction detection, two-way measurement method was used to detect the median nerve, ulnar nerve, peroneal nerve and peroneal nerve sensory branch, and the nerve stimulation thresholds of different age groups were obtained, the single factor analysis of variance was used in the statistical analysis of the results. Results The healthy volunteers were divided into 6 groups by age, which was 20 - 29 years old group（group A）, 30 - 39 years old group（group B）, 40 - 49 years old group（group C）, 50 - 59 years old group（group D）, 60 - 69 years old group（group E） and 1〉 70 years old group（group F）, with 20 cases in each group. There were significant differences between group F and group A, B and C in median nerve and ulnar nerve stimulation threshold, and there was no significant difference between the other groups. The stimulation threshold of median nerve, ulnar nerve, peroneal nefve and superficial peroneal increased gradually with age, especially in the elderly group（≥ 70 years old）, the threshold of nerve stimulation was significantly higher than that of the younger group（20 - 40 years old group）. There was no significant difference in the threshold of nerve stimulation between different genders. The lower e
作者
羊洁
刘英
冯建华
YANG Jie LIU Ying FENG Jian- hua(Department of Neurology, Sichuan People＇s Hospital, Chengdu 610072, Sichuan, China)
出处
《生物医学工程与临床》
CAS
2017年第3期254-257,共4页
Biomedical Engineering and Clinical Medicine
关键词
神经刺激阈值
神经兴奋性
周围神经
运动传导
感觉传导
neural stimulation threshold
nerve excitability
peripheral nerve
motor conduction
sensory conduction
