法医学杂志

法医学杂志 ›› 2013, Vol. 29 ›› Issue (3): 172-175.DOI: 10.3969/j.issn.1004-5619.2013.03.004

• 论著 • 上一篇    下一篇

经颅磁刺激运动诱发电位对脊髓损伤的评价及法医学意义

杨  蕾1，刘兴本2，朱镕霆2，徐晓明2，郑传斐2，周禹鑫3   

  1. （1. 新联司法鉴定所，浙江 嘉兴 314000； 2. 中国医科大学法医学院，辽宁 沈阳 110001； 3. 中国医科大学附属盛京医院康复中心，辽宁 沈阳 110001）
  • 发布日期:2013-06-25 出版日期:2013-06-28
  • 通讯作者: 刘兴本，男，教授，硕士研究生导师，主要从事法医临床学教学、研究及鉴定；E-mail：XBLiu@mail.cmu.edu.cn
  • 作者简介:杨蕾（1985—），男，安徽安庆人，硕士研究生，主要从事法医临床学研究；E-mail：yanglei248@126.com

The Evaluation of SCI by TMS-MEP and Its Forensic Significance

YANG LEI1, LIU XING-BEN2, ZHU RONG-TING2, XU XIAO-MING2, ZHENG CHUAN-FEI2, ZHOU YU-XIN3   

  1. （1. Xinlian Institute of Forensic Medicine, Jiaxing 314000, China; 2. School of Forensic Medicine, China Medical University, Shenyang 110001, China; 3. Rehabilitation Center of Shengjing Hospital, China Medical University, Shenyang 110001, China）
  • Online:2013-06-25 Published:2013-06-28

被引次数

3

摘要： 目的 为脊髓损伤（spinal cord injury，SCI）的法医临床学鉴定寻找客观且准确的检查方法。 方法 采用经颅磁刺激运动诱发电位（transcranial magnetic stimulation-motor evoked potential，TMS-MEP）测定68例SCI患者（颈段损伤23例，胸腰段损伤45例）拇短展肌和胫前肌的皮层起始潜伏期、N1峰潜伏期、中枢运动传导时间（central motor conduction time，CMCT）和波宽，并以30例正常人作为对照，比较两组差异。 结果 实验组随拇短展肌、胫前肌肌力下降或消失，皮层起始潜伏期、N1峰潜伏期、CMCT延长，波宽增宽，且实验组中的2、3级肌力者上述指标均高于对照组（P＜0.05）。 结论 TMS-MEP检测可以直接、客观地反映脊髓锥体束的运动功能状态，为法医学鉴定提供更客观、准确的依据。

关键词: 法医学, 脊髓损伤, 诱发电位, 运动, 经颅磁刺激

Abstract: Objective To find an objective and accurate examination for evaluation of spinal cord injury （SCI） in forensic clinical medicine. Methods The onset latency of cortex, peak latency of N1, central motor conduction time （CMCT） and wave width of the abductor pollicis brevis and the anterior tibialis were calculated by transcranial magnetic stimulation-motor evoked potential （TMS-MEP）. The data of 68 patients suffered from SCI including 23 cervical levels and 45 thoracolumbar levels were collected and compared with that of 30 normal controls. Results In experimental group, when the muscle strength of the abductor pollicis brevis or the anterior tibialis decreased or disappeared, the onset latency of cortex, the peak latency of N1, and CMCT prolonged and the wave width broadened. And these indexes of grade 2 and 3 muscle strength in experimental group were higher than that in the control group （P<0.05）. Conclusion The TMS-MEP can determine directly and objectively the motor functional status of pyramidal tract of spinal cord in order to provide more accurate and objective evidences in forensic medicine.

Key words: forensic medicine, spinal cord injury, evoked potentials, motor, transcranial magnetic stimulation

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