脊髓亚急性联合变性患者神经损害的影响因素及肌电图改变

摘要

Objective To investigate the influencing factors of neural damages on patients with subacute combined degeneration of spinal cord(SCD) and their electromyographic changes.Methods Clinical data of 42 SCD patients were collected and their degrees of neural damages were evaluated.Linear correlation analysis between Vit B12 level,hemoglobin concentration and degree of neural damage was performed, and their electromyographic changes were summarized.Results There was no significant relationship between Vit B12 level,hemoglobin concentration and neural damage score(P>0.05).18 patients(42.9%) had reduced conduction velocity of motor nerves and prolonged distal latency,8 of them had reduced amplitudes of motor evoked potential.24 patients(57.1%) had reduced conduction velocity of sensory nerves,10 of them had reduced amplitudes of somatosensory evoked potential.Conclusions There is no linear correlationship between Vit B12 level,anemia degree and neural damage degree in SCD patients.Both motor and sensory nerves could be damaged in SCD patients,but sensory nerves are more involved.The peripheral nervous damage is mainly neural demyelination,and axonal damage can also exist.%目的：探讨脊髓亚急性联合变性（subacute combined degeneration of spinal cord，SCD）患者神经损害的影响因素及肌电图改变特点。方法收集42例确诊为SCD患者的临床资料并进行神经损害程度积分评定，分析血清VitB12、血红蛋白水平与神经损害程度的相关性，并总结其肌电图特点。结果 VitB12水平及血红蛋白浓度与神经损害程度积分均无显著相关（P＞0.05)。18例（42.9%）有运动神经传导速度减慢、远端潜伏期延长，其中8例伴有运动诱发电位波幅降低；24例（57.1%）有感觉神经传导速度减慢，10例伴有体感诱发电位波幅降低。结论 SCD神经损害程度与VitB12水平及贫血程度之间无线性相关；运动神经和感觉神经均可受损，但感觉神经更易累及；损害以神经脱髓鞘改变为主，可伴有轴索损伤。