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[铅中毒人群神经肌肉功能的电生理研究]

[Electrophysiological study of neuromuscular function in a population poisoned by lead].

作者信息

Genovese O M, Panizza M, Conti H, Battle A, Sica R E

机构信息

División Neurología, Hospital J. M. Ramos Mejía, Buenos Aires, Argentina.

出版信息

Arq Neuropsiquiatr. 1988 Mar;46(1):16-21. doi: 10.1590/s0004-282x1988000100005.

Abstract

A comprehensive electrophysiological examination of the peripheral nervous system was carried out in 12 patients who proved to be toxicated with lead (high lead blood levels, and diminished activity of the delta-aminolevulinate dehydratase, ALA D, in erythrocytes). Maximal motor nerve conduction velocities and terminal latencies were investigated in the median, radial and deep peroneal nerves. Also the amplitude of the evoked muscle response (M wave) was measured in thenar, extensor longus and extensor digitorium brevis muscles. Sensory conduction velocity and amplitude of the nerve compound action potential were measured at the median nerve. Tibialis anterior muscle responses to deep peroneal nerve repetitive stimulation were also explored. Conventional needle electromyogram was performed in the deltoid and tibialis anterior muscles. Slight diminished motor and sensory conduction velocities were found as well as a reduction of the amplitude of the evoked muscle response of the compound sensory action potential. Four out of the 12 patients tested showed either decremental or incremental amplitude of the muscle response with nerve repetitive stimulation. A electromyographical diminished interference pattern was found in all patients tested. Most of the remaining motor unit potentials were fragmented or polyphasic. Just one patient disclosed potentials of enhanced duration and amplitude. No relationship was found between blood lead levels or ALA D erythrocytes concentration and the different electrophysiological tests performed, except between reduced ALA D concentration and diminished amplitudes of the M wave and of the sensory compound action potential, and also between ALA D and diminished radial motor conduction velocity.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

对12名经证实铅中毒(血铅水平高,红细胞中δ-氨基乙酰丙酸脱水酶(ALA D)活性降低)的患者进行了外周神经系统的全面电生理检查。研究了正中神经、桡神经和腓深神经的最大运动神经传导速度和终末潜伏期。还测量了拇短展肌、趾长伸肌和趾短伸肌诱发肌肉反应(M波)的幅度。在正中神经处测量感觉传导速度和神经复合动作电位的幅度。还探究了胫前肌对腓深神经重复刺激的反应。对三角肌和胫前肌进行了常规针极肌电图检查。发现运动和感觉传导速度略有降低,复合感觉动作电位的诱发肌肉反应幅度也有所降低。在接受测试的12名患者中,有4名患者的肌肉反应幅度在神经重复刺激时出现递减或递增。在所有接受测试的患者中均发现肌电图干扰模式减弱。其余的大多数运动单位电位均为时限缩短或多相波。只有一名患者的电位时限和幅度增大。除了ALA D浓度降低与M波和感觉复合动作电位幅度降低之间,以及ALA D与桡神经运动传导速度降低之间外,未发现血铅水平或红细胞ALA D浓度与所进行的不同电生理测试之间存在关联。(摘要截短为250字)

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