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[使用针电极进行肌电图检查以分析神经肌肉疾病中运动单位的结构和功能状态]

[Electromyography using needle electrodes to analyze the structure and functional state of motor units in neuromuscular diseases].

作者信息

Gekht B M, Kasatkina L F, Kevish A V

出版信息

Zh Nevropatol Psikhiatr Im S S Korsakova. 1980;80(6):822-9.

PMID:7415703
Abstract

Results of electromyographic examinations of over 1,000 patients with various forms of acute and chronic neuromuscular diseases and progressing myodystrophies are analyzed. The examinations were carried out with the use of needle electrodes. On comparing the electromyographic findings with the clinical ones and with the results of examining muscle biopsy specimens 5 electromyographic stages of motor unit changes occurring in the course of the development and compensation of the pathological process were differentiated. Stage I was characterized by a shortening of the duration of the activity potentials in some motor units, with the average duration of the motor unit activity potentials remaining unchanged. In Stage II the average duration of the motor unit activity potentials, due to a considerable shortening of most of them, diminishes by more than 20%. In Stage III, along with the short-duration potentials there appear much longer potentials with a duration exceeding the normal ones. Characteristic for Stages IV and V was prevalence of long motor unit activity potentials the average duration of which was by 20 to 40% greater than that of the normal ones. Data characterizing the degree of the spontaneous activity of muscular fibres (potentials of fibrillations and positive acute waves), as well as the spontaneous activity of the motor units (fasciculations) in various stages of their impairment are presented. The importance of evaluating the motor unit activity potentials and the spontaneous activity of the muscular fibres for diagnosing and studying the mechanisms of the development of neuromuscular diseases is discussed.

摘要

分析了1000多名患有各种急慢性神经肌肉疾病和进行性肌营养不良症患者的肌电图检查结果。检查使用针电极进行。将肌电图检查结果与临床结果以及肌肉活检标本检查结果进行比较后,区分出了病理过程发展和代偿过程中运动单位变化的5个肌电图阶段。第一阶段的特征是一些运动单位动作电位的持续时间缩短,而运动单位动作电位的平均持续时间保持不变。在第二阶段,由于大多数动作电位大幅缩短,运动单位动作电位的平均持续时间减少超过20%。在第三阶段,除了短持续时间的电位外,还出现了持续时间超过正常电位的长得多的电位。第四和第五阶段的特征是长运动单位动作电位占优势,其平均持续时间比正常电位长20%至40%。给出了表征肌纤维自发活动程度(纤颤电位和正锐波)以及运动单位在其损伤各阶段的自发活动(肌束震颤)的数据。讨论了评估运动单位动作电位和肌纤维自发活动对诊断和研究神经肌肉疾病发展机制的重要性。

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