单纤维传导对腕管综合征运动纤维损伤的早期评价
Early evaluation of the single-fiber conduction studies of motor nerve damage in carpal tunnel syndrome
目的:应用单纤维神经传导技术,评价腕管综合征( carpal tunnel syndrome , CTS)感觉性神经病早期运动纤维功能状态。方法根据AANEM推荐标准和常规神经传导结果选取40例CTS患者,其中正中神经感觉传导异常( SCA)组20例,即仅有感觉传导异常而运动传导正常者;感觉运动异常( SMCA)组20例,即感觉和运动传导均异常者;同期健康志愿者20名作为对照。应用Keypoint.net ( Medoc Ltd )肌电图仪,采用鞍状刺激电极刺激,单纤维针电极记录,获取正中神经腕到拇短展肌潜伏期。结果 SCA 组、SMCA 组和对照组的正中神经单纤维传导潜伏期( ms )分别为3.92±0.28、4.71±0.49、3.41±0.31(F=63.829, P=0.000),其对CTS患者运动纤维损害的诊断具有较好的准确性,其受试者工作特征曲线下面积为0.920,截点值特异度达到85%。结论 CTS感觉神经病患者存在临床下运动纤维卡压损害。单纤维神经传导技术较常规神经传导检测对发现CTS运动纤维早期卡压损伤更为敏感。
更多Objective To evaluate the function status of motor nerve in patients with carpal tunnel syndrome ( CTS) sensory neuropathy by single-fiber conduction studies ( SF-CS).Methods Forty patients with CTS were divided into two groups according to the nerve conduction abnormality of median nerve .The sensory conduction abnormalities ( SCA) group included 20 patients with abnormal sensory conduction , while the sensory motor conduction abnormalities ( SMCA) group included 20 patients with abnormal motor sensory conduction.The Keypoint.net electromyogram device was used to detect the wrist to the abductor pollicis brevis latency , using the saddle shaped stimulating electrodes for stimulating and the single fiber electromyography electrode for recording.The control group included 20 healthy people.Results The latency of single-fiber conduction of median nerve in SCA group , SMCA group and control group was (3.92 ±0.28) ms, (4.71 ±0.49) ms and (3.41 ±0.31) ms (F=63.829, P=0.000), respectively.The area under the receiver operating characteristic curve was 0.920 for the latency of single-fiber conduction of median nerve , and its specificity was 85%in cut off point.Conclusions There is clinical motor nerve damage in patients with CTS sensory neuropathy.The SF-CS may become an effective means for early evaluation of motor nerve function state.
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