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膈神经传导及膈肌肌电活动的测定是评价呼吸功能障碍的客观指标,磁刺激的膈运动诱发电位可用来评价呼吸肌中枢运动传导功能和完整性。本文对50例健康志愿者作了正常值的研究。(1)电刺激的潜伏期和波幅无侧别和年龄的差异,但性别有差异,男性为7.3ms、女性6.8ms;波幅的正常变异较大。潜伏期与身高无关,但与刺激到记录点之间的距离均有关(男性r=0.42、潜伏期(ms)=5.19+0.07×距离(mm),女性r=0.45、潜伏期=3.77+0.10×距离)。电刺激的PNC技术简便、快速、无创,而且可以成功地进行;但检测过程中应避免刺激臂丛。(2)颈7棘突磁刺激的潜伏期无侧别、年龄的差异,但有性别的差异,男性为11.5ms、女性为11.1ms。(3)经颅磁刺激的膈MEPs在深吸气时,其检出率较平静呼吸时的高得多(97%/26%),且潜伏期较短(14.7/15.8mms)、波幅较高(196/130μV),这是由于反应的易化所致。
The measurement of phrenic nerve conduction and diaphragmatic myoelectric activity is an objective index to evaluate respiratory dysfunction. Magnetic stimulation of phrenic motor evoked potential can be used to evaluate the function and integrity of respiratory motor center. In this paper, 50 healthy volunteers made a normal value study. (1) The latency and amplitude of electrical stimulation had no side-to-age and age differences, but the gender differences were 7.3 ms for males and 6.8 ms for females. The normal variation of amplitude was larger. The latency was independent of height, but was related to the distance between stimuli and recording points (r = 0.42 for men, 5.19 for 0.07 × distance for mm, r = 0.45 for women, and latency = 3.77 + 0.10 × distance). Electro-stimulated PNC technique is simple, rapid, noninvasive and can be successfully performed; however, stimulation of the brachial plexus should be avoided during the test. (2) There was no difference of age and age between the magnetic stimulation of cervical spine and spinous process, but there was a gender difference of 11.5ms for males and 11.1ms for females. (3) The transcranial magnetic stimulation of the diaphragm MEPs showed a much higher detection rate (97% / 26%) and a shorter incubation period (14.7 / 15.8 mms) during deep inspiration, Higher volatility (196 / 130μV), which is due to the facilitation of the reaction.