摘要
目的研究中枢运动传导时间(CMCT)与皮质脊髓束受损体征的关系及其临床应用。方法选取2020年6月至2021年6月首都医科大学宣武医院行四肢经颅磁刺激运动诱发电位检查的神经内科患者,比较病理征及腱反射阳性组与阴性组CMCT值的差异,评估CMCT延长程度与皮质脊髓束损害体征的一致性,以及二者一致性在不同神经系统疾病中的意义。结果共纳入患者271例,年龄12~86(49±16)岁,其中男137例(50.55%),女134例(49.45%)。Hoffmann征阳性组[M(Q_(1),Q_(3))][9.52(8.54,10.99)ms比9.03(8.30,9.53)ms]、Babinski征阳性组[19.54(16.97,24.43)ms比16.85(15.63,18.55)ms]及腱反射阳性组[15.38(9.27,19.28)ms比10.49(8.79,16.60)ms]CMCT值均较阴性组长(均P<0.01)。在Babinski征阳性组中,78.01%(181/232)患者CMCT延长;而在Hoffmann征阳性组中,仅26.03%(19/73)患者CMCT延长,提示下肢CMCT延长与病理征阳性的一致性较上肢好。随着下肢CMCT延长率的升高,Babinski征阳性率升高,差异有统计学意义(P<0.001)。在神经系统疾病中CMCT与病理征的一致性为75.65%(205/271)。结论下肢CMCT延长与皮质脊髓束受损体征一致性较上肢好。随着CMCT延长率升高,提示皮质脊髓束受损的可靠性更高。在神经系统疾病中CMCT与病理征一致时,可以更准确协助临床诊断。
Objective To investigate the association of central motion conduction time(CMCT)with corticospinal tract lesions and its clinical application.Methods Patients who completed transcranial magnetic stimulation-motor evoked potentials were included from Department of Neurology,Xuanwu Hospital between June 2020 and June 2021.The differences of CMCT values between corticospinal tract sign-positive group and tendon reflex-positive group and the relevant negative groups were compared.The consistency between increased CMCT values and the positive signs of corticospinal tract damage,as well as the significance of CMCT in different neurological diseases were further evaluated.Results A total of 271 patients were included in the study,aged 12-86(49±16)years,with 137 males(50.55%)and 134 females(49.45%).The CMCT values[M(Q_(1),Q_(3))]from Hoffmann′s sign-positive group[9.52(8.54,10.99)ms vs 9.03(8.30,9.53)ms],Babinski′s sign-positive group[19.54(16.97,24.43)ms vs 16.85(15.63,18.55)ms]and tendon reflex-positive group[15.38(9.27,19.28)ms vs 10.49(8.79,16.60)ms]were larger than those of relevant negative groups(all P<0.01).In the Babinski sign-positive group,78.01%(181/232)of the patients had increased CMCT,while in the Hoffmann′s sign-positive group,only 26.03%(19/73)of the patients had increased CMCT,indicating that the contribution of CMCT from the lower extremities to the assessment of corticospinal tract lesions was better than that of the upper extremities.With the increase of CMCT values in lower limbs,Babinski sign positive rate increased,the difference was statistically significant(P<0.001).In nervous system diseases,the consistency between CMCT and pathological signs was 75.65%(205/271).Conclusions The contribution of CMCT from the lower extremities to the assessment of corticospinal tract lesions is superior to that of upper limbs.The higher increase of CMCT values are more reliable for corticospinal tract damage.CMCT has a good concordance with corticospinal tract lesions in some neurological diseases,which ca
作者
王淑楠
李思燃
宋鹏辉
武晓昱
林华
Wang Shu'nan;Li Siran;Song Penghui;Wu Xiaoyu;Lin Hua(Department of Neurology,Xuanwu Hospital,Capital Medical University,Beijing 100053,China;Department of Neurology,Beijing Fengtai Youanmen Hospital,Beijing 100069,China;Department of Neurology,Anyang District Hospital,Puyang 455000,China)
出处
《中华医学杂志》
CAS
CSCD
北大核心
2022年第25期1918-1923,共6页
National Medical Journal of China
关键词
诱发电位
运动
中枢运动传导时间
皮质脊髓束
横断面研究
Evoked potentials,motor
Central motion conduction time
Pyramidal tracts
Cross‑sectional study
