脊髓损伤患者交感神经皮肤反应的变化

Sympathetic skin response due to spinal cord injury

中文关键词:  脊髓损伤  交感神经皮肤反应  自主神经功能

英文关键词:Spinal cord injury  Sympathetic skin response  Autonomic dysreflexia

中文摘要:

  【摘要】 目的：观察不同程度脊髓损伤（SCI）患者交感神经皮肤反应（SSR）的变化，探讨SSR对SCI后自主神经功能评定的价值。方法：选择10例完全性SCI患者（T5及以上3例，T8~T11 7例；平均病程6.2个月）作为观察CS组；10例不完全性SCI患者（T6及以上5例，T7~L3 5例；平均病程11.1个月）作为观察IS组；正常健康受试者20例作为对照H组，分别给予仰卧位下左眶上神经、左正中神经、左胫神经电刺激诱发SSR，同时表面电极置于双掌心和双足心记录SSR波引出率。结果：H组20例受试者3处刺激4个部位记录SSR均可引出。CS组3处神经刺激4个部位（左、右掌心，左、右足心）记录SSR引出例数分别为：左眶上神经7、7、3、3，左正中神经7、7、2、2，左胫神经2、2、1、1，3处刺激4个部位记录SSR引出率均较H组降低（P<0.05）。IS组3处神经刺激4个部位记录SSR引出例数分别为：左眶上神经9、9、8、7，左正中神经9、9、6、6，左胫神经7、7、5、5，左正中神经刺激双足心记录SSR引出率较H组降低（P<0.05），左胫神经刺激时四肢记录SSR引出率均较H组降低（P<0.05）。结论：SCI患者SSR引出率降低，SSR可作为SCI患者自主神经功能评估的方法之一。

英文摘要:

  【Abstract】 Objective：To investigate the sympathetic skin response（SSR） due to spinal cord injury（SCI） of different degree and to identify the value of SSR on assessing the autonomic function after SCI.Method：There were 10 patients with complete SCI（3 above T5，7 between T8 and T11） and with the mean course of 6.2 months termed as CS group and 10 patients with incomplete SCI（5 above T6，5 between T7 and L3） and with the mean course of 11.1 months termed as IS group.Meanwhile，20 normal healthy subjects were tested as control H group.All patients lied supine on the bed with the electrical stimulation in left supra orbital nerve，median nerve and tibial nerve respectively to induce SSR.At the same time，the surface recording electrodes were set at the bilateral palms of two hands and soles of feet.The rate of SSR was recorded in each group.Result：The SSR in the 20 normal subjects always presented regardless of the position of electrode.After stimulating left supra orbital nerve with each record electrode（left/right palms and left/right soles），the number of patients presenting SSR was 7，7，3 and 3 respectively，while for median nerve was 7，7，2，2 and for tibial nerve was 2，2，1，1 in CS group.The presenting rates of SSR in CS group decreased more compared to H group（P<0.05） regardless of the electrode position.In IS group，after stimulating left supra orbital nerve，median nerve and tibia nerve，the number of patients presenting SSR was 9，9，8，7；9，9，6，6 and 7，7，5，5 respectively.The rates of sole-SSR when stimulating left median nerve and sole-SSR/palm-SSR when stimulating tibial nerve in IS group decreased more compared with H group（P<0.05）.Conclusion：The rates of SSR in the SCI patients decrease，which can be used to assess the autonomic function in SCI patients.