本文的目的是定出國人正常青年人上肢複合肌肉動作電位波型之正常值及其擴散情形。共有三十位男性青年志願者接受測試,年齡介於二十五至三十五歲之間,以正中神經及尺神經為測試部位,分別於雙手之腕、肘下、及腋下做超大電量刺激,並記錄其負相振幅、間期及表面積,以比較不同刺激位置對於複合肌肉動作電位各項參數的影響。結果顯示正中神經腕至肘下之負相間期,振幅及表面積之擴散百分比分別為2.89%,5.12%,7.68%;腕至腋下各項參數之擴散百分比分別為6.99%,4.46%,1.98%。尺神經腕至肘下各項參數之擴散百分比分別為1.34%,6.96%,8.30%;腕至腋下各項參數之擴散百分比分別為3.98%,14.66%,13.66%。除在腕至腋下刺激所記錄之尺神經複合肌肉動作電位的振幅有統計學上的差異之外,其餘均無顯著差異。本研究結論為正常青年人上肢複合肌肉動作電位之波型,會有愈靠近身體近端,振幅愈小,而間期愈長,且負向表面積愈小的情形。本文並且定出特定年齡層之青年人上肢複合肌肉誘發電位振幅、間期及負向表面積的正常範圍及擴散比率,以作為臨床醫師日後檢查時的參考依據。
The aim of this investigation is to define the normal values and the boundaries of compound muscle action potential (CMAP) dispersion of a specific age group in Chinese population. Measurements were made from median and ulnar motor nerves of 30 normal volunteers, age between 25-35 years. Supramaximal stimulations were applied to wrist, elbow and axilla of median and ulnar nerves individually. Negative peak areas, amplitudes and durations were recorded and the percentage of dispersion were calculated for each parameter. The results show that the percentage of negative duration, amplitude and area decay between wrist and below-elbow stimulation sites are 2.89%, 5.12% and 7.68% in median nerve; 1.34%, 6.96% and 8.30% in ulnar nerve. Dispersion ratios between wrist and axilla stimulation sites are 6.99%, 4.46% and 1.98% in median nerve; 3.98%, 14.66% and 13.66% in ulnar nerve. The conclusion of this study is that the negative areas and amplitudes decrease while the negative durations increased in proximal stimulations. These data should increase the accuracy of clinical examination in differentiating normal subjects from demyelinating neuropathies.
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