目的 探讨髂腰肌肌电图在诊断多发性肌炎中的应用价值。方法 回顾性收集2018-01至2019-02于首都医科大学附属北京天坛医院就诊并确诊为多发性肌炎的28例患者(多发性肌炎组)的临床资料,以及年龄、性别相匹配的健康人20名(对照组),就其髂腰肌、股四头肌、三角肌肌电图自发电位和小力收缩运动单位电位(motor unit action potential, MUAP)进行分析。结果 对照组髂腰肌未检测出自发电位,多发性肌炎组髂腰肌自发电位阳性率为57.14%(16/28),显著高于对照组(P<0.001);另外其MUAP波幅显著低于对照组[(424.20±82.41)μV vs. (593.93±65.49 )μV,P<0.001],MUAP时限也显著短于对照组[(9.73±2.05)vs. (11.26±0.42) ms,P<0.01]。在肌肉病患者中,股四头肌自发电位阳性率为35.71%(10/28),三角肌自发电位阳性率为25.00%(7/28),三角肌自发电位显著低于髂腰肌(P<0.05)。结论 髂腰肌在多发性肌炎患者中有明显的肌源性损害的表现,可为临床提供更加敏感、客观的诊断依据。
Abstract
Objective To investigate the applicability of iliopsoas electromyography (EMG) in the diagnosis of polymyositis. Methods The clinical data on 28 patients diagnosed with polymyositis and treated in Beijing Tiantan Hospital between January 2018 and February 2019 was retrospectively analyzed, and another 20 healthy age- and gender-matched people served as the control. The spontaneous potentials and motor unit action potential (MUAP) of the iliopsoas, quadriceps femoris and deltoid were compared between the two groups. Results No spontaneous potential [positive sharp wave (PSW) or fibrillation potential] was detected in the iliopsoas muscle of the healthy controls. In patients with polymyositis, the rate of spontaneous potential in the iliopsoas was 57.14% (16/28), which was significantly higher than that of healthy controls (P<0.001). In addition, the MUAP amplitude [(424.20±82.41) μV vs. (593.93±65.49) μV,P<0.001] and duration [(9.73±2.05) ms vs. (11.26±0.42)ms, P<0.01] of the iliopsoas in patients with polymyositis was significantly decreased compared with healthy controls. In polymyositis patients, the rate of spontaneous potential in the deltoids (25.00%, 7/28) was significantly lower (P<0.05) than in the iliopsoas. Conclusions Spontaneous potentials in the iliopsoas have a more sensitivity in polymyositis, which can provide an Objective basis for clinical diagnosis.
关键词
多发性肌炎 /
髂腰肌 /
针极肌电图 /
自发电位
Key words
polymyositis /
iliopsoas /
electromyography /
spontaneous potentials
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