Frijns C J, Laman D M, van Duijn M A, van Duijn H
Department of Clinical Neurophysiology, St Lucas Hospital, Amsterdam, The Netherlands.
Clin Neurol Neurosurg. 1997 Feb;99(1):31-6. doi: 10.1016/s0303-8467(96)00593-8.
The clinical value of latency measurement of tendon reflexes in neurological patients has been reported by several authors. However, normal values are not readily comparable. In the present study, latencies and amplitudes of patellar (PTR) and ankle tendon reflexes (ATR) were measured at rest and after facilitation in 102 normal controls. A manually operated reflex hammer, tipped with electrically conductive rubber, ensured an immediate start of the sweep of the oscilloscope. Latencies showed a significant correlation with height (r = 0.70 for PTR and r = 0.72 for ATR, P < 0.0001) and to a lesser degree with age (r = 0.16 and r = 0.30, P < 0.0001). While amplitudes were highly variable, rendering them less useful for diagnostic purposes, latencies showed minimal intra-individual variability (CV 1.5 and 0.8%, respectively). Correlation of ATR-latency with the H-reflex latency of the soleus muscle was very high (r = 0.97, P < 0.0001). Comparison with three other hammer types yielded corresponding results with a hammer supplied with a piezo-electric element; however, significantly shorter latencies were found with a hammer with a microswitch, and with another hammer with a spring-contact, due to a delay from the tap on the tendon until the start of the sweep of the monitor.
几位作者报告了神经科患者肌腱反射潜伏期测量的临床价值。然而,正常数值不易比较。在本研究中,对102名正常对照者在静息状态下以及在易化后测量了髌腱反射(PTR)和跟腱反射(ATR)的潜伏期及波幅。一个装有导电橡胶头的手动反射锤确保示波器扫描立即开始。潜伏期与身高显著相关(髌腱反射r = 0.70,跟腱反射r = 0.72,P < 0.0001),与年龄的相关性较小(r = 0.16和r = 0.30,P < 0.0001)。虽然波幅变化很大,使其对诊断用途的价值较小,但潜伏期个体内变异性最小(分别为CV 1.5%和0.8%)。跟腱反射潜伏期与比目鱼肌H反射潜伏期的相关性非常高(r = 0.97,P < 0.0001)。与其他三种类型的反射锤比较,使用配有压电元件的反射锤得到了相应结果;然而,使用带有微动开关的反射锤以及另一种带有弹簧触点的反射锤时,由于从敲击肌腱到监视器扫描开始存在延迟,发现潜伏期明显更短。