目的: 探讨POEMS综合征的神经肌电图特征,为疾病的早期识别提供参考依据。方法: 回顾性分析8例POEMS综合征患者(观察组)的神经肌电图特征,对比患者上、下肢的神经传导及F波出现率差异,并与对照组(同时期内进行肌电图检查的8例健康体检者)的神经传导和针肌电图指标进行对比。结果: 观察组感觉神经动作电位(sensory nerve action potential,SNAP)引出率(41.7 %)低于复合肌肉动作电位(compound muscle action potential,CMAP)(81.3 %)(P＜0.05),下肢CMAP引出率(62.5 %)低于上肢(100 %)(P＜0.05),下肢SNAP引出率(0.0 %)低于上肢(62.5 %),胫神经F波引出率(0.0 %)低于正中神经(100 %)。与对照组相比,观察组运动传导末端潜伏期(distal motor latency,DML)延长、运动神经传导速度(motor nerve conduction velocity,MCV)减慢、波幅(amplitude,AMP)降低(P＜0.05),感觉传导AMP降低、感觉神经传导速度(sensory nerve conduction velocity,SCV)减慢(P＜0.05),胫神经F波引出率明显下降、正中神经F波平均潜伏期延长(P＜0.05),尺神经远端潜伏期指数(TIL)增高(P＜0.05);观察组针极肌电图异常率24.1 %,其中胫前肌异常率最高。结论: POEMS综合征患者运动神经、感觉神经均受累,传导速度与波幅均异常,F波异常率高,针电极肌电图可出现神经源性损害。
Objective: To analyze the characteristics of electromyography (EMG) in POEMS syndrome and provide a reference for the disease identification. Methods: The EMG of 8 patients with POEMS syndrome in our hospital (patient group) has been analyzed in detail. The extraction rate of compound muscle action potential(CMAP), sensory nerve action potential(SNAP) and F-wave of upper and lower limbs has been compared. The CMAP and SNAP amplitude (AMP), motor nerve conduction velocity (MCV), sensory nerve conduction velocity (SCV), distal motor latency (DML), the F-wave latency of median nerve and tibial nerve, the terminal latency index (TLI) of median and ulnar nerve, and the needle pole electromyography (EMG) has been statistically analyzed with the healthy control group as a reference. Results: In the patient group,the appearance of SNAP was lower than that of CMAP (P＜0.05), the appearance of CMAP and SNAP was apparently higher in the upper limb than in the lower limb(P＜0.05), The F-wave extraction rate of median nerve (100 %) was higher than that of tibial nerve (0 %). In comparison with the control group , the DML was prolonged, the CMAP and SNAP amplitude was decreased, the MCV and SCV was slowed down, the F-wave extraction rate of tibial nerve was decreased, and the latency of median nerve F-wave was longer in the patient group (P＜0.05). The ulnar nerve terminal latency index (TLI) in the patients group was significantly higher than that in the normal group (P＜0.05). The abnormal rate of needle electromyography was 24.14 % in the patient group, and the abnormal rate of anterior tibial muscle was the highest (50 %). Conclusion: Motor nerve and sensory nerve conduction are all abnormal in POEMS patients, F-wave abnormal rate is high, electromyography may appear neurogenic damage, tibialis anterior muscle was the most commonly involved.
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