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坐骨神经痛电诊断中的腱反射

The tendon reflexes in the electrodiagnosis of sciatica.

作者信息

Zabelis T, Karandreas N, Lygidakis C

机构信息

Department of Neurology, Athens University, Aeginition Hospital, Greece.

出版信息

Electromyogr Clin Neurophysiol. 1995 Apr-May;35(3):175-80.

PMID:7649064
Abstract

In order to determine the diagnostic value of the electromyographically tested tendon reflexes (ETR) in lumbosacral radiculopathies, we compared the latency and amplitude of the knee (EKTR) and Achilles tendon reflex (EATR) to their clinical testing and to the EMG and H reflex values in 200 non selected patients (126 men, 74 women) aged 24-68 years (48.6 +/- 9.4). The control group was composed of 50 healthy volunteers (28 men, 22 women) aged 25-60 yrs (44 +/- 8.5). The combined electrophysiological reflex examination was abnormal in 45% of the affected limbs, being the most frequent pathological finding. EMG was abnormal in 34.4% and H reflex in 30.4% of the affected limbs. Furthermore, the EATR taken separately was more sensitive than the H-reflex (42.8% versus 30.4%). Pathological ETR were elicited in a considerable percentage of the clinically normal tendon reflexes (TR): 7.3% of the knee and 14.1% of the Achilles TR. On the other hand 65% of the clinically absent ATR were recorded electrically producing abnormally low and delayed muscle evoked potentials.

摘要

为了确定经肌电图测试的腱反射(ETR)在腰骶神经根病中的诊断价值,我们比较了200例年龄在24 - 68岁(48.6±9.4)的未经过挑选的患者(126名男性,74名女性)的膝腱反射(EKTR)和跟腱反射(EATR)的潜伏期及波幅,以及它们与临床检查结果、肌电图和H反射值的关系。对照组由50名年龄在25 - 60岁(44±8.5)的健康志愿者(28名男性,22名女性)组成。在45%的患侧肢体中,联合电生理反射检查结果异常,这是最常见的病理表现。在34.4%的患侧肢体中肌电图异常,30.4%的患侧肢体中H反射异常。此外,单独检测的EATR比H反射更敏感(42.8%对30.4%)。在相当比例的临床检查中正常的腱反射(TR)中引出了病理性ETR:7.3%的膝腱反射和14.1%的跟腱反射。另一方面,65%临床检查未引出的跟腱反射经电检测显示肌肉诱发电位异常低且延迟。

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