肌萎缩侧索硬化症患者分裂腿现象分析
R741; 目的 分析肌萎缩侧索硬化症(ALS)患者的腓总神经和胫神经复合肌肉动作电位波幅(CMAP)的特点,并阐明分裂腿现象及其临床价值.方法 通过对比88例下肢受累ALS患者、100例正常人及24例腰椎病患者的腓总神经和胫神经CMAP特点,分析腓总神经与胫神经CMAP之比,即分裂腿比(SLI)在3组间的差异,并通过ROC曲线分析SLI对于鉴别ALS和腰椎病患者的特异性和敏感性.结果 ①胫神经CMAP在ALS患者中显著高于腰椎病患者[(7.06±3.86)mV vs.(3.31±1.72)mV,P<0.001],腓总神经CMAP在ALS患者和腰椎病患者两组间无统计学差异[(2.49±1...
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| Published in | 西安交通大学学报（医学版） Vol. 39; no. 5; pp. 620 - 633 |
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| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | Chinese |
| Published |
西安交通大学第一附属医院神经内科,陕西西安,710061
01.09.2018
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1671-8259 |
| DOI | 10.7652/jdyxb201805002 |
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| Abstract | R741; 目的 分析肌萎缩侧索硬化症(ALS)患者的腓总神经和胫神经复合肌肉动作电位波幅(CMAP)的特点,并阐明分裂腿现象及其临床价值.方法 通过对比88例下肢受累ALS患者、100例正常人及24例腰椎病患者的腓总神经和胫神经CMAP特点,分析腓总神经与胫神经CMAP之比,即分裂腿比(SLI)在3组间的差异,并通过ROC曲线分析SLI对于鉴别ALS和腰椎病患者的特异性和敏感性.结果 ①胫神经CMAP在ALS患者中显著高于腰椎病患者[(7.06±3.86)mV vs.(3.31±1.72)mV,P<0.001],腓总神经CMAP在ALS患者和腰椎病患者两组间无统计学差异[(2.49±1.35)mV vs.(2.41±1.57)mV,P=0.925],ALS患者中胫前肌失神经电位半定量显著于高于腓肠肌(χ2=61.70,P<0.001);②SLI在ALS、正常对照和腰椎病患者3组间有统计学差异(H=4.571,P=0.001),ALS患者SLI显著低于正常对照和腰椎病患者(P<0.001),正常对照和腰椎病患者两组间SLI无统计学差异(P=0.023);③SLI与病程、ALSFRS-r评分及疾病进展率均无明显相关性(Rs=-0.008,P=0.94;Rs=0.073,P=0.498;Rs=-0.082,P=0.519);④ROC曲线显示SLI可用于鉴别ALS和腰椎病患者,最佳截断值为0.634,敏感性=63.4％(95％CI=44.68％ ～84.37％),特异性=75％(95％CI=61.03％ ～77.69％),阳性预测值=88.1％.结论 分裂腿现象是下肢受累的ALS患者早期即可出现的特异性神经电生理特征,有助于ALS的早期诊断和鉴别诊断,可作为ALS早期诊断的电生理学标志物. |
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| AbstractList | R741; 目的 分析肌萎缩侧索硬化症(ALS)患者的腓总神经和胫神经复合肌肉动作电位波幅(CMAP)的特点,并阐明分裂腿现象及其临床价值.方法 通过对比88例下肢受累ALS患者、100例正常人及24例腰椎病患者的腓总神经和胫神经CMAP特点,分析腓总神经与胫神经CMAP之比,即分裂腿比(SLI)在3组间的差异,并通过ROC曲线分析SLI对于鉴别ALS和腰椎病患者的特异性和敏感性.结果 ①胫神经CMAP在ALS患者中显著高于腰椎病患者[(7.06±3.86)mV vs.(3.31±1.72)mV,P<0.001],腓总神经CMAP在ALS患者和腰椎病患者两组间无统计学差异[(2.49±1.35)mV vs.(2.41±1.57)mV,P=0.925],ALS患者中胫前肌失神经电位半定量显著于高于腓肠肌(χ2=61.70,P<0.001);②SLI在ALS、正常对照和腰椎病患者3组间有统计学差异(H=4.571,P=0.001),ALS患者SLI显著低于正常对照和腰椎病患者(P<0.001),正常对照和腰椎病患者两组间SLI无统计学差异(P=0.023);③SLI与病程、ALSFRS-r评分及疾病进展率均无明显相关性(Rs=-0.008,P=0.94;Rs=0.073,P=0.498;Rs=-0.082,P=0.519);④ROC曲线显示SLI可用于鉴别ALS和腰椎病患者,最佳截断值为0.634,敏感性=63.4％(95％CI=44.68％ ～84.37％),特异性=75％(95％CI=61.03％ ～77.69％),阳性预测值=88.1％.结论 分裂腿现象是下肢受累的ALS患者早期即可出现的特异性神经电生理特征,有助于ALS的早期诊断和鉴别诊断,可作为ALS早期诊断的电生理学标志物. |
| Author | 靳娇婷 刘晨昱 胡芳芳 刘潇 秦星 党静霞 康丽 贾蕊 王亮 张荣华 |
| AuthorAffiliation | 西安交通大学第一附属医院神经内科,陕西西安,710061 |
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| Author_FL | ZHANG Rong-hua JIN Jiao-ting LIU Chen-yu KANG Li WANG Liang QIN Xing JIA Rui DANG Jing-xia HU Fang-fang LIU Xiao |
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| Author_xml | – sequence: 1 fullname: 胡芳芳 – sequence: 2 fullname: 靳娇婷 – sequence: 3 fullname: 秦星 – sequence: 4 fullname: 康丽 – sequence: 5 fullname: 贾蕊 – sequence: 6 fullname: 刘潇 – sequence: 7 fullname: 刘晨昱 – sequence: 8 fullname: 张荣华 – sequence: 9 fullname: 王亮 – sequence: 10 fullname: 党静霞 |
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| Keywords | 肌萎缩侧索硬化症 神经传导 分裂腿 复合动作电位波幅 |
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| Title | 肌萎缩侧索硬化症患者分裂腿现象分析 |
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