Zhuang Li, Tang Xiaofu, Xu Xianhao, Li Benhong, Du Hua, Jiang Jingwen
Department of Neurology, Beijing Hospital, The fifth Hospital, Peking University, Beijing 100730, China.
Zhonghua Yi Xue Za Zhi. 2002 Feb 10;82(3):152-4.
To investigate the features and application of phrenic nerve conduction in amyotrophic lateral scle-rosis (ALS) patients.
The latency and amplitude of diaphragmatic compound muscle action potential (DCMAP) were recorded among 44 ALS patients and 31 control subjects with surface electrodes after the cervical part of phrenic nerve was stimulated with electricity. The percentage of forced vital capacity (%FVC) was examined in 28 ALS patients simultaneously.
Right and left phrenic distal motor latencies (PDML) of ALS patients were 8.4 ms +/- 2.2 ms and 7.6 ms +/- 1.4 ms respectively, longer than those of the controls, and the logarithmic value of amplitudes among ALS patients was 2.68 +/- 0.37, lower than that among the controls. Take the right side for example, although PDML was correlated with %FVC, it had no correlation with clinical respiratory dysfunction. Neither %FVC nor clinical respiratory dysfunction was correlated with the amplitude of DCMAP. The rate of abnormal PDML (47.7%) was higher than the rate of clinical dyspnea (25%).
PDML is a sensitive index in phrenic conduction parameter reflecting respiratory dysfunction in ALS. Only when the PDML is combined with the central motor conduction time of the diaphragmatic motor evoked potential the nervous system basis of the respiratory disturbance in ALS can be revealed.
探讨肌萎缩侧索硬化症（ALS）患者膈神经传导的特点及应用。
对44例ALS患者和31例对照者用电刺激膈神经颈部后，用表面电极记录膈肌复合肌肉动作电位（DCMAP）的潜伏期和波幅。同时对28例ALS患者进行用力肺活量（%FVC）检查。
ALS患者右侧和左侧膈神经远端运动潜伏期（PDML）分别为8.4 ms±2.2 ms和7.6 ms±1.4 ms，长于对照组，ALS患者波幅对数值为2.68±0.37，低于对照组。以右侧为例，虽然PDML与%FVC相关，但与临床呼吸功能障碍无关。%FVC和临床呼吸功能障碍均与DCMAP波幅无关。异常PDML率（47.7%）高于临床呼吸困难率（25%）。
PDML是反映ALS患者呼吸功能障碍的膈神经传导参数中的敏感指标。只有将PDML与膈肌运动诱发电位的中枢运动传导时间相结合，才能揭示ALS患者呼吸障碍的神经系统基础。
