Quantitative analysis on characteristics of electromyography and evoked potential in normal laryngeal muscles
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目的 定量分析正常喉肌肌电图及神经诱发电位特征及影响因素、参考值范围及变异度.方法 纳入2012年6月至2022年6月于首都医科大学附属北京同仁医院诊断为"单侧声带活动不良"并行喉肌电图检查的患者480例,其中男259例,女221例;年龄(44.4±14.9)岁.测定患者健侧甲杓肌(TA)、环杓后肌(PCA)及环甲肌(CT)运动单位电位(motor unit potential,MUP)、募集相及神经诱发电位参数,分析不同性别间差异及随年龄变化特征,计算各参数变异系数(coefficient of variation,CV)及参考值.以SPSS 24.00软件对数据进行统计学分析.结果 TA、PCA、CT的MUP波幅分别为(129.52±24.95)、(240.67±88.25)、(125.88±21.36)μV;时程分别为(3.67±0.17)、(3.82±0.29)、(3.68±0.17)ms;相位数分别为1.94±0.28、2.16±0.38、1.98±0.25.TA、PCA、CT的募集相转折数分别为(565.76±193.88)、(520.94±170.99)、(523.29±159.58)个/s,波幅分别为(1 038.00±368.65)、(1 269.91±434.75)、(919.64±240.54)µV.TA、PCA、CT的喉神经诱发电位潜伏期分别为(1.69±0.08)、(1.70±0.08)、(1.70±0.11)ms,时程分别为(6.20±1.30)、(6.41±1.34)、(7.05±1.67)ms,波幅分别为(7.42±3.62)、(6.05±2.83)、(5.54±2.62)mV.男性健侧 TA(t=5.70,P＜0.01)、CT(t=2.41,P＜0.05)的 MUP时程高于女性,差异有统计学意义;男性喉返神经甲杓肌支(t=3.63)、喉返神经环杓后肌支(t=3.21)、喉上神经外支(t=2.98)的诱发电位时程均高于女性,差异有统计学意义(P值均＜0.01).PCA诱发电位波幅与年龄呈负相关(r=-0.17,P＜0.01).TA、PCA及CT的MUP时程参考值分别为3.30～3.90、3.40～4.30、3.30～3.90ms,诱发电位潜伏期集中在1.70ms,变异系数均＜10％.结论 本研究分析了单侧声带活动不良患者健侧正常喉肌的MUP、募集相及神经诱发电位判定标准及正常参考值范围.MUP时程及神经诱发电位潜伏期变异度较小.男性TA及CT的MUP及各喉肌神经诱发电位时程高于女性,喉肌各参数随年龄变化趋势不明显.
Objective To quantitatively analyze and explore the characteristics,influencing factors,reference value range,and variability of electromyography and nerve evoked potential in normal laryngeal muscles.Methods The study included 480 patients diagnosed with unilateral vocal fold immobility and underwent laryngeal electromyography(LEMG)at Beijing Tongren Hospital from June 2012 to June 2022,including 259 males and 221 females,with an average age of(44.4±14.9)years.Characteristics of the motor unit potential(MUP),recruitment pattern,and evoked potential in the thyroarytenoid muscle(TA),the posterior cricoarytenoid muscle(PCA)and the cricothyroid muscle(CT)of the normal side were analyzed,with the coefficient of variation(CV),reference value range of each parameter,and differences in different genders and age groups analyzed simultaneously.SPSS 24.0 software was used to analyze the data.Results The amplitudes of MUP in TA,PCA,and CT muscles were(129.52±24.95)μV,(240.67±88.25)μV,and(125.88±21.36)μV,respectively.The durations were(3.67±0.17)ms,(3.82±0.29)ms and(3.68±0.17)ms,respectively.The numbers of MUP phase were 1.94±0.28,2.16±0.38,and 1.98±0.25,respectively.The per second numbers of turns in TA,PCA,and CT muscles were 565.76±193.88,520.94±170.99,and 523.29±159.58,respectively.The amplitudes of the recruitment pattern were(1 038.00±368.65)μV,(1 269.91±434.75)μV,and(919.64±240.54)μV,respectively.The latencies of laryngeal nerve evoked potentials in TA,PCA,and CT muscles were(1.69±0.08)ms,(1.70±0.08)ms,and(1.70±0.11)ms,with durations of(6.20±1.30)ms,(6.41±1.34)ms,and(7.05±1.67)ms,respectively.The amplitudes were(7.42±3.62)mV,(6.05±2.83)mV,and(5.54±2.62)mV,respectively.The duration of MUP in male laryngeal muscles was higher than that in females,with statistical differences in TA(t=5.70,P＜0.01)and CT(t=2.41,P＜0.05)muscles,and the duration of evoked potentials was higher than that in females(TA:t=3.63;PCA:t=3.21;CT:t=2.98;all P＜0.01).The duration of PCA evoked potentials was weakly negatively correlated with age(r=-0.17,P＜0.01).The reference ranges for MUP duration in TA,PCA,and CT muscles were(3.30-3.90)ms,(3.40-4.30)ms,and(3.30-3.90)ms,respectively,and the latencies of the evoked potential were concentrated at 1.70 ms,the CVs were all less than 10％.Conclusions This study analyzes the parameters of MUP,recruitment pattern,and evoked potential in laryngeal muscles of the normal side in patients with unilateral vocal fold immobility,as well as the normal reference range.Among them,the duration of MUP and the latency of evoked potential are relatively small,which can be used as characteristic indicators for normal laryngeal muscles and nerves.MUP of TA and CT muscles in male patients,as well as the duration of all the evoked potentials,are higher than those in females,and the trend of changes in the parameters with age is not significant.
Laryngeal musclesElectromyographyEvoked potential,motorMotor unit potentialRecruitment pattern
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