摘要
目的分析肌萎缩侧索硬化(amyotrophic lateral sclerosis,ALS)的F波特点及上运动神经元损害对F波的影响。方法纳入确诊和很可能ALS(改良EI Escorial标准)患者52例为ALS组,性别、年龄、身高匹配的健康志愿者37名为对照组。根据上肢有无锥体束征,把ALS组分为有锥体束征组和无锥体束征组。所有对象进行常规电生理检测,采集与临床评估同侧肢体的正中神经末端运动潜伏期(distal motor latency,DML)、神经复合肌肉动作电位(compound muscle action potential,CMAP)峰-峰波幅和F波最大峰-峰波幅(F wave maximal peak-to-peak amplitude,FAmax)、FAmax/M波峰-峰波幅比(F/M)、重复F波及巨大F波百分比。结果与对照组比较,ALS组F/M(0.05±0.02 vs.0.15±0.15)、F波重复率[0(0,10.0%)vs.67.0%(34.2%,87.8%)]、神经元重复率[0(0,5.3%)vs.34.2%(14.2%,60.0%)]和巨大F波百分比[0(0,0)vs.0(0,12.1%)]明显升高,均有统计学差异(P<0.05)。与ALS无锥体束征组比较,ALS有锥体束征组F波波幅[(0.50±0.40)mv vs.(1.14±0.80)mv]、F/M[0.06(0.02,0.11)vs.0.12(0.07,0.23)]、F波重复率[31.5%(0,50.8%)vs.77.8%(53.8%,94.7%)]及神经元重复率[13.0%(0,33.0%)vs.50.0%(23.8%,75.0%)]显著升高(P<0.05)。有锥体束征组中,13例(38%)患者正中神经可见巨大F波,无锥体束征组未见巨大F波。结论ALS患者上运动神经元损害可关键性引起脊髓运动神经元兴奋性增高,可表现为FAmax、F/M增高,且巨大和重复F波增多。
Objective To analyze the F wave characteristics of ALS and the influence of upper motor neuron(UMN)dysfunctions on F wave.Methods Fifty-two patients who met the revised EI criteria for definite and probable diagnosis ALS were enrolled and 38 healthy volunteers,matched to gender,age and height,were recruited as the control group.ALS groups were divided into two groups based on the presence or absence of pyramidal signs in upper limb,the group with pyramidal signs and the group without pyramidal signs.Standard electrophysiology studies were performed in all participants and distal motor latency(DML),compound muscle action potential(CMAP)peak-to-peak amplitude,F-wave maximal peak-to-peak amplitude(FAmax),FAmax/M-wave peak-to-peak amplitude ratio(F/M),the percentage of repeated and huge F wave of median nerve were collected.Results Compared with control group,F/M(0.05±0.02 vs.0.15±0.15),F-wave repetition rate(Frep)[0(0,10.0%)vs.67.0%(34.2%,87.8%)],neuronal repetition rate(Nrep)[0(0,5.3%)vs.34.2%(14.2%,60.0%)]and percentage of huge F waves[0(0,0)vs.0(0,12.1%)]in ALS increased significantly(P<0.05).Compared with the group without pyramidal signs,FAmax[(0.50±0.40)mv vs.(1.14±0.80)mv],F/M[0.06(0.02,0.11)vs.0.12(0.07,0.23)],Frep[31.5%(0,50.8%)vs.77.8%(53.8%,94.7%)]and Nrep[13.0%(0,33.0%)vs.50.0%(23.8%,75.0%)]of the group with pyramidal signs significantly increased(P<0.05).Huge F waves in the median nerve could be detected in the group with pyramidal signs,13(38%)but no in the group without pyramidal signs.Conclusion Present study suggests that UMN dysfunctions critically lead to hyper-excitability of spinal motoneuron,exhibiting the increases in FAmax,F/M amplitude ratio and percentage of repeater F and huge F waves.
作者
王恒恒
陈娜
翦凡
张磊
王颖
张在强
潘华
WANG Hengheng;CHEN Na;JIAN Fan;ZHANG Lei;WANG Ying;ZHANG Zaiqiang;PAN Hua(Department of Neurology,Beijing Tiantan Hospital,Capital Medical University,China National Clinical Research Center for Neurological Diseases,Beijing 100070,China)
出处
《中国神经精神疾病杂志》
CAS
CSCD
北大核心
2021年第10期586-590,共5页
Chinese Journal of Nervous and Mental Diseases
关键词
F波
肌萎缩侧索硬化
上运动神经元损害
F wave
Amyotrophic lateral sclerosis
Upper motor neuron dysfunctions
