Zhou Xu-hui, Jia Lian-shun, Yuan Wen, Zhang Yun-zhi, Zhang Yong, Yan Wang-jun
Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China.
Zhonghua Wai Ke Za Zhi. 2007 Mar 15;45(6):387-9.
To study the change of motor evoked potential of the diaphragm after graded upper cervical cord injuries and analyze the prognosis of the respiratory function after upper cervical cord injuries by MEP.
The C(3, 4) spinal cord of 40 SD rats were injured with modified Allen method by weight drop force of 30 gcf, 50 gcf, 80 gcf, 100 gcf. The change of latent and amplitude of MEP of the diaphragm was observed before and after the spinal cord injuries (followed up for 1 month). At the same time, the femoral arterial blood of 0.2 ml was drawn. The pH value, the partial pressure of oxygen, the partial pressure of carbon dioxide, and the saturation of the blood oxygen were monitored. The change of the respiratory function was evaluated in the rats after cervical cord injuries. The relationship between the recovery of the respiratory function and the latent or amplitude was analyzed.
The MEP wave of the diaphragm was stable before the upper cervical spinal cord injury in the rats. It was usually composed of a positive and negative wave. The latent period and peak-peak amplitude of wave were (3.13 +/- 0.29) ms and (6.78 +/- 3.48) mv. The latent period of the diaphragms MEP in rats change with graded upper cervical cord injuries significantly, the more sever the injury, the longer the latent period. There were obvious relationship between the change of the latent period and the recovery of the respiratory function. When the latent period prolonged 101%, the respiratory function is hardly to recovery.
MEP can objectively and sensitively reflect the injury extent of the respiratory function when upper cervical cord is injured. It would be a reliable index to evaluate the long-term prognosis of respiratory function.
研究上颈段脊髓损伤分级后膈肌运动诱发电位的变化,并通过运动诱发电位分析上颈段脊髓损伤后呼吸功能的预后。
采用改良的Allen法,分别以30gcf、50gcf、80gcf、100gcf的重量落差对40只SD大鼠的C(3,4)脊髓进行损伤。观察脊髓损伤前后(随访1个月)膈肌运动诱发电位潜伏期和波幅的变化。同时抽取0.2ml股动脉血,监测pH值、血氧分压、二氧化碳分压和血氧饱和度。评估颈髓损伤大鼠呼吸功能的变化。分析呼吸功能恢复与潜伏期或波幅之间的关系。
大鼠上颈段脊髓损伤前膈肌运动诱发电位波形稳定,通常由正负波组成,波的潜伏期和峰峰值波幅分别为(3.13±0.29)ms和(6.78±3.48)mv。大鼠膈肌运动诱发电位潜伏期随上颈段脊髓损伤分级变化显著,损伤越严重,潜伏期越长。潜伏期变化与呼吸功能恢复之间存在明显关系。当潜伏期延长101%时,呼吸功能几乎难以恢复。
运动诱发电位能客观、敏感地反映上颈段脊髓损伤时呼吸功能的损伤程度,是评估呼吸功能长期预后的可靠指标。