Zheng Chaojun, Lyu Feizhou, Ma Xiaosheng, Xia Xinlei, Jin Xiang, Yin Jun, Jiang Jianyuan, Zhu Yu
Department of Orthopedics, Huashan Hospital, Fudan University, Shanghai 200040, China.
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Zhonghua Wai Ke Za Zhi. 2015 Feb;53(2):95-100.
To identify whether there is significant changes between the cervical neutral F-waves and cervical flexion F-waves in the patients with Hirayama disease.
This study was performed on 25 normal subjects and 22 male patients with identified Hirayama disease (age: 15 to 44 years; height: 165 to 183 cm; duration: 6 to 240 months) between May 2010 and March 2014. Both cervical flexion F-wave (cervical flexion 45 °, 30 minutes) and conventional F-waves to median nerve stimulation and to ulnar nerve stimulation were performed in all subjects bilaterally.
were analyzed by t-test or Fisher exact probability.
In the normal subjects, all measurements of the bilateral F-waves didn't have any difference between the cervical flexion position and the cervical neutral position. On the cervical neutral position, the persistence (t = 5.209, P = 0.000), average latencies (t = 4.731, P = 0.022) and minimal latencies (t = 23.843, P = 0.006) of ulnar F-wave on the symptomatic heavier side from the patients with identified Hirayama disease were significantly lower or longer than those from the normal subjects, and the repeat F-waves were found in 3 patients (13.6%). On the symptomatic lighter side, the ulnar F-waves only had lower persistence (t = 22.306, P = 0.001) along with 5 repeat F-waves. Only lower persistence were found in the median F-wave on the both side (higher side t = 23.696, P = 0.000; lighter side t = 23.998, P = 0.000), along with 5 (22.7%) repeat F-waves on the symptomatic heavier side and 6 (27.3%) ones on the symptomatic lighter side. After cervical flexion maintaining 30 minutes, the increased maximal amplitudes (t = -2.552, P = 0.019), average amplitudes (t = -3.322, P = 0.003), duration (t = -3.323, P = 0.00), persistence (t = -2.604, P = 0.017) and frequency of repeat F-waves (9/22, 41%) (P = 0.044) were found on the symptomatic heavier side of ulnar F-wave, and 5 of 10 absent ulnar F-wave on the cervical neutral position were also recover. The median F-wave on the symptomatic heavier side mainly had increased maximal amplitude (t = -3.847, P = 0.001), average amplitudes (t = -2.188, P = 0.040) and persistence (t = -2.421, P = 0.025), and 1 of 6 absent median F-wave on the cervical neutral position were also recover after cervical flexion.
The cervical flexion F-waves have significant regular changes compared to the cervical neutral F-waves in patients with Hirayama diseases, especially maximal and average amplitudes of F-waves.
确定平山病患者颈部中立位F波与颈部前屈F波之间是否存在显著变化。
本研究于2010年5月至2014年3月对25名正常受试者和22名确诊为平山病的男性患者（年龄：15至44岁；身高：165至183 cm；病程：6至240个月）进行。所有受试者双侧均进行颈部前屈F波（颈部前屈45°，30分钟）以及正中神经和尺神经刺激的常规F波检查。
采用t检验或Fisher精确概率法进行分析。
在正常受试者中，双侧F波的所有测量值在颈部前屈位和颈部中立位之间均无差异。在颈部中立位时，确诊平山病患者症状较重侧尺神经F波的出现率（t = 5.209，P = 0.000）、平均潜伏期（t = 4.731，P = 0.022）和最小潜伏期（t = 23.843，P = 0.006）显著低于或长于正常受试者，且3例患者（13.6%）出现重复F波。在症状较轻侧，尺神经F波仅出现率较低（t = 22.306，P = 0.001），伴有5例重复F波。双侧正中神经F波仅出现率较低（症状较重侧t = 23.696，P = 0.000；症状较轻侧t = 23.998，P = 0.000），症状较重侧有5例（22.7%）重复F波，症状较轻侧有6例（27.3%）重复F波。颈部前屈30分钟后，症状较重侧尺神经F波的最大波幅（t = -2.552，P = 0.019）、平均波幅（t = -3.322，P = 0.003）、时限（t = -3.323，P = 0.00）、出现率（t = -2.604，P = 0.017）以及重复F波频率（9/22，41%）（P = 0.044）均增加，且颈部中立位时10例未引出的尺神经F波中有5例恢复。症状较重侧正中神经F波主要表现为最大波幅（t = -3.847，P = 0.001）、平均波幅（t = -2.188，P = 0.040）和出现率（t = -2.421，P = 0.025）增加，颈部中立位时6例未引出的正中神经F波中有1例在颈部前屈后恢复。
与颈部中立位F波相比，平山病患者颈部前屈F波有显著的规律性变化，尤其是F波的最大波幅和平均波幅。
