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痉挛性斜颈患者骨骼肌缺血诱导的电活动。

Electrical activity induced by ischemia in the skeletal muscle of patients with spasmophilia.

作者信息

Bonciocat C, Stoicescu N, Vacariu A, Lazăr M, Vulpe C

机构信息

D. Danielopolu Institute of Normal and Pathological Physiology, Bucharest, Romania.

出版信息

Physiologie. 1988 Jan-Jun;25(1-2):35-41.

PMID:3133673
Abstract

The incidence of spontaneous electrical activity during ischemia was studied in normal and spasmophilic subjects with a Bronk electrode inserted in the first dorsal interosseous muscle. Subjects were of both sexes, aged 16 to 65 years. The diagnosis of spasmophilia was established electromyographically by a variant of the Alajouanine test. Ischemia induced in many cases an electrical activity consisting of discharge potentials that have the amplitude, duration and morphology of motor unit potentials. The number of discharging motor units varied, sometimes leading to an electrical Trousseau associated to a carpal spasm. The discharge of individual motor units was irregular and practically uninfluenced by passive manipulations on the muscle or voluntary contraction. The activity started usually 30 sec to 1 min after the onset of ischemia, reached a maximal intensity (as to the number of motor units and frequency of discharge) in about 1 min and declined gradually in the following minutes. This activity was encountered in 55.06% of 770 cases of spasmophilia and only in 11.66% of 283 normal subjects, with a tendency to more intense discharge in spasmophilia. Its incidence in the spasmophilic group was closely related to the intensity of spontaneous repetitive discharges appearing electromyographically after the activation test, reaching 78.63% in most severe cases. The behaviour was interpreted as indicating a higher susceptibility in spasmophilia of axons to depolarization induced by hypoxia. This higher susceptibility appears as an important component of the excitability alterations leading to the complex neuromuscular disorders occurring in spasmophilia.

摘要

采用Bronk电极插入第一背侧骨间肌,研究正常人和易痉挛者在缺血期间的自发电活动发生率。受试者为16至65岁的男女。易痉挛症的诊断通过Alajouanine试验的一种变体经肌电图确定。在许多情况下,缺血会诱发一种电活动,其由具有运动单位电位的幅度、持续时间和形态的放电电位组成。放电运动单位的数量各不相同,有时会导致与腕部痉挛相关的电Trousseau征。单个运动单位的放电不规则,且几乎不受对肌肉的被动操作或随意收缩的影响。该活动通常在缺血开始后30秒至1分钟开始,在约1分钟内达到最大强度(就运动单位数量和放电频率而言),并在随后几分钟逐渐下降。在770例易痉挛症患者中有55.06%出现这种活动,而在283例正常受试者中仅11.66%出现,易痉挛症患者的放电倾向更强。其在易痉挛症组中的发生率与激活试验后肌电图显示的自发放电重复放电强度密切相关,在最严重的病例中达到78.63%。这种表现被解释为表明易痉挛症患者的轴突对缺氧诱导的去极化更敏感。这种更高的敏感性似乎是导致易痉挛症中发生的复杂神经肌肉障碍的兴奋性改变的一个重要组成部分。

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