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目的探索建立健康人周围神经刺激阈值的正常值范围,初步探讨年龄、性别对周围神经刺激阈值的影响。方法选取符合纳入标准的健康志愿者120例,其中男性58例,女性62例;年龄20~79岁,平均年龄49.3岁。采用Keypoint workstation肌电图及诱发电位仪,带通20 Hz~10 kHz(运动传导检测)或1 Hz~2 kHz(感觉传导检测),扫描速度每格5 ms,灵敏度每格5 mV(运动传导检测)或每格20μV(感觉传导检测),刺激频率1 Hz,刺激时限0.2 ms。检查时室温27℃~30℃,保证健康志愿者皮肤温度在30℃以上。在神经传导检测的基础上采用双向测量法分别对正中神经、尺神经、腓神经及腓浅神经感觉支进行检测,得到各神经不同年龄组的神经刺激阈值,并对结果进行统计学分析。结果将健康志愿者按照年龄分为6组,即20~29岁组(A组)、30~39岁组(B组)、40~49岁组(C组)、50~59岁组(D组)、60~69岁组(E组)、≥70岁组(F组),每组20例。采用单因素方差分析,正中神经与尺神经刺激阈值F组与A组、B组、C组间差异有统计学意义;腓神经和腓浅神经感觉支刺激阈值F组与A组、B组间差异有统计学意义;其余各组间差异无统计学意义。正中神经、尺神经、腓神经及腓浅神经感觉支神经刺激阈值随年龄增长有逐渐增大趋势,尤其高龄组(≥70岁),其神经刺激阈值明显高于低龄组(20~40岁组)。不同性别间同名神经刺激阈值差异无统计学意义。上下肢比较发现,下肢神经刺激阈值明显高于上肢。结论采用双向测量法检测周围神经刺激阈值是可行的;年龄对神经刺激阈值的影响虽然微小但的确存在,尤其对于老年人;性别对于神经刺激阈值没有显著影响,这一点尚需深入研究进一步明确;上下肢神经刺激阈值的差异可能与其生理功能差异、神经纤维长度有关。
Objective To explore the normal range of peripheral nerve stimulation threshold in healthy individuals and to explore the influence of age and gender on the peripheral nerve stimulation threshold. Methods A total of 120 healthy volunteers who met the inclusion criteria were selected, including 58 males and 62 females, aged from 20 to 79 years with a mean age of 49.3 years. Using Keypoint workstation electromyography and evoked potentiometer, bandpass 20 Hz ~ 10 kHz (motion conduction detection) or 1 Hz ~ 2 kHz (sensory conduction detection), scanning speed of 5 ms per cell, sensitivity of 5 mV per cell (motion conduction Test) or 20μV per cell (sensory conduction test), stimulation frequency 1 Hz, stimulation time limit 0.2 ms. Check the room temperature 27 ℃ ~ 30 ℃, to ensure that healthy volunteers skin temperature above 30 ℃. On the basis of nerve conduction test, the median nerve, ulnar nerve, peroneal nerve and peroneal nerve sensory branch were detected by two-way measurement. The neural stimulation thresholds of different age groups were obtained, and the results were statistically analyzed. Results The healthy volunteers were divided into 6 groups according to their age, namely, 20-29 years old group A, 30-39 years old group B, 40-49 years old group C, 50-59 years old group D, Group, 60-69 years old group (E group), 70 years old group (F group), 20 cases in each group. One-way analysis of variance (ANOVA) showed that there was significant difference between group F and group A, group B and group C, and between group F and group F, group F and group F The difference was statistically significant; the remaining differences between the groups was not statistically significant. The threshold of median nerve, ulnar nerve, peroneal nerve and superficial peroneal sensory nerve increased gradually with increasing age, especially in the elder group (≥70 years), the threshold value of nerve stimulation was significantly higher than that in the younger group (20-40 years old group) ). There was no significant difference in thresholds of nerve stimulation with the same name between different genders. Upper and lower limbs found that lower limb nerve stimulation threshold was significantly higher than the upper limbs. CONCLUSION: It is feasible to measure the peripheral nerve stimulation threshold by bidirectional measurement. Although the effect of age on the threshold of neural stimulation is small, it does exist, especially for the elderly. However, gender has no significant effect on the threshold of neural stimulation. The difference of upper and lower limb nerve stimulation thresholds may be related to their differences in physiological functions and nerve fiber length.