多系統萎縮症患者の仙骨反射特性．

Sacral Reflex Characteristics of Patients with Multiple System Atrophy.

• Zhifang Pan
• Xueming Zhang
• Xun Wang
• Binbin Deng
• Wanli Zhang
• Huanjie Huang

抄録

目的:

多系統萎縮症（MSA）患者における仙骨反射と下肢神経体性感覚誘発電位（SSEP）のパラメータを年齢、病勢、サブタイプなどの因子について観察・解析し、MSAの臨床診断のエビデンスを提供することを目的とする。

Objectives: To observe and analyze the parameters of the sacral reflex and pudendal nerve somatosensory evoked potential (SSEP) in patients with multiple system atrophy (MSA) with respect to factors such as age, disease course, and subtype and provide evidence for the clinical diagnosis of MSA.

材料と方法:

2013 年 5 月から 2015 年 11 月までの間に温州医科大学第一附属病院から MSA 患者 51 例と健常対照 30 例を抽出した。電気生理学的仙骨反射検出およびSSEP検出はKeypoint EMG/EPシステムを用いて行った。MSA群と対照群の仙骨反射とSSEPの抽出率、潜時、振幅を比較した。

Materials and Methods: A total of 51 MSA patients and 30 healthy controls were selected from the First Affiliated Hospital of Wenzhou Medical University from May 2013 to November 2015. Electrophysiological sacral reflex detection and SSEP detection were performed using the Keypoint EMG/EP system. The extraction rate, latency, and amplitude of the sacral reflex and SSEP in the MSA group and control group were compared.

結果:

MSA患者の仙骨反射潜時および振幅は健常者と統計的に異なっていた。仙骨反射の潜時は病期の延長に伴い増加し、振幅および開始率は病期の延長に伴い減少した。仙骨反射の潜時および振幅には，年齢およびサブタイプの異なるMSA患者間で有意差は認められなかった．仙骨反射の潜時および振幅には、MSA群と健常対照群との間で有意差は認められなかった。

Results: The sacral reflex latency and amplitude in patients with MSA were statistically different from those of the healthy controls. The latency of sacral reflex increases with the prolongation of the disease course, and the amplitude and initiation rate decrease with the prolongation of the disease course. There was no significant difference in sacral reflex latency and amplitude between MSA patients of different ages and subtypes. There was no significant difference in the latency or amplitude of SSEP between the MSA group and healthy control group.

結論:

仙骨反射の潜時は疾患経過の延長に伴い増加し，振幅と抽出率は疾患経過の延長に伴い減少した．仙骨反射のパラメータには、若年MSA患者と高齢者との間に有意な差はなかった。また、MSA-PサブタイプとMSA-Cサブタイプの間には統計学的に有意な差は認められなかった。本試験はISRCTNCR2009041に登録されている。

Conclusions: The latency of sacral reflex increases with the prolongation of the disease course, and the amplitude and extraction rate decrease with the prolongation of the disease course. There was no significant difference in the parameters of sacral reflex between young MSA patients and elderly patients. And there was no statistically significant difference between MSA-P subtypes and MSA-C subtypes. This trial is registered with ISRCTNCR2009041.

Copyright © 2020 Zhifang Pan et al.