临床神经病学杂志2025，Vol.38Issue(6)：432-437,6.
ICU获得性肌无力的影响因素及肌电图改变
Influencing factors and electromyographic changes of ICU-acquired weakness
摘要
Abstract
Objective To investigate the risk factors and EMG changes associated with patients with ICU-acquired weakness(ICU-AW).Methods Clinical data of patients with muscle weakness who were admitted to the ICU of the First Affiliated Hospital of Nanjing Medical University from January 1,2021 to April 30,2025,and underwent examinations in the EMG room were retrospectively collected.According to the diagnostic criteria for ICU-AW,patients were divided into ICU-AW group and control group.Baseline clinical data,laboratory test results,and EMG findings were compared between the two groups.Multivariable Logistic regression analysis was employed to identify factors influencing the occurrence of ICU-AW,and ROC curve analysis was used to evaluate the predictive efficacy of relevant factors for ICU-AW.Results A total of 87 patients were included,with 55 in the ICU-AW group and 32 in the control group.The ICU-AW group had a significant lower proportion of males and lower serum albumin(ALB)levels compared to the control group(all P＜0.05).The ICU-AW group had significant higher rates of sepsis and use of intravenous nutrition,as well as significant higher serum urea nitrogen(BUN)and pro-B-type natriuretic peptide(pro-BNP)levels compared to the control group(all P＜0.05).Among these factors,BUN(OR=1.001)and pro-BNP(OR=1.062)were identified as independent risk factors for ICU-AW(all P＜0.05).ICU-AW group exhibited significantly lower compound muscle action potential amplitudes in the ulnar,median,tibial and common peroneal nerves compared to the control group(all P=0.001).The motor and sensory nerve conduction velocities of the ulnar and median nerves were significantly slower(all P＜0.05),and the sensory nerve action potential amplitude of the sural nerve was significantly lower(P=0.001)in the ICU-AW group.The F-wave occurrence rates in both the upper and lower limbs were significantly lower in the ICU-AW group(all P=0.001),while the spontaneous potential occurrence rate was significantly higher(P=0.001).Conclusions ICU patients who are female,have sepsis,receive intravenous nutrition,have low ALB,high BUN,and high pro-BNP levels are more susceptible to develop ICU-AW.Among these,high BUN and high pro-BNP are independent risk factors for ICU-AW.Nerve damage is predominant in ICU-AW patients,with concurrent axonal damage in both sensory and motor fibers,particularly in motor fibers.EMG is an important diagnostic tool for this condition.关键词
ICU获得性肌无力/危险因素/EMGKey words
ICU-acquired weakness/risk factors/EMG分类
医药卫生引用本文复制引用
孙美,高甜文,程虹,史兆春,王国珍,秦晓旋..ICU获得性肌无力的影响因素及肌电图改变[J].临床神经病学杂志,2025,38(6):432-437,6.基金项目
国家自然科学基金项目(82101497) （82101497）
江苏省自然科学基金项目(BK20210967) （BK20210967）
