强直性肌营养不良的肌肉电生理及病理研究
Myotonic dystrophy: Pathological and electrophysiological study on 8 patients
-
摘要: 目的: 探讨强直性肌营养不良症(myoton ic dystrophy,DM)的骨骼肌病理及电生理变化间的相互关系。方法: 分析8例DM患者肌肉病理和电生理特点,并比较两者间的相互关系。结果: 所有病例均呈典型的强直性肌营养不良的病理变化,其中Ⅰ型纤维占优势4例,Ⅱ型纤维占优势4例。肌电图变化特点为肌强直电位及肌原性损害,神经传导速度均在正常值范围内。按活检I型或II型纤维优势将肌电图检测结果分成两组后,I型纤维优势患者的自发电位插入延长率(83.3%)、MUP时限缩短程度(36.8%)及多相波比例(24.4%)均明显高于II型优势者(16.7%,19.3%,11.0%;χ2=14.9610,P=0.000,F isher exact=0.000;t=2.7253/3.1901,P=0.0102,P=0.0030)。结论: DM的电生理改变程度与病理变化中的优势纤维类型相关。Abstract: Objective:To identify the relationship between pathological features and electrophysiological changes in patients with myotonic dystrophy(DM).Methods:Eight subjects diagnosed as myotonic dystrophy in PLA General Hospital were studied about their muscle pathological findings,routine electromyography(EMG) and nerve conductive velocity(NCV) changes retrospectively.Results:Classical myopathic changes of DM were found in these muscle biopsies.With ATPase staining,there was no consistent abnormality of fiber type distribution,with 4 specimen having type I predominance and 4 having type II predominance.EMG was abnormal in all patients showed potentials of myotonia and myogenic damage.Compared with the cases with type II predominance,the rates of insert spontaneous potentials extension,the degree of motor unit potentials(MUP) duration shortening,and the percentage of polyphasic potentials were higher in the cases with type I predominance(83.3% vs 16.7%: χ2=14.9610,P= 0.000,Fisher’s exact=0.000;36.8% vs 19.3%: t=2.7253,P=0.0102;and 24.4% vs 11.0%: t=3.1901,(P=0.0030).)Conclusion:In patients with DM the severity of the myoelectrophysiological changes were related to the pathological features,especially to the predominant fibre type.
下载: