中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2013, Vol. 8 ›› Issue (15): 1418-1422.doi: 10.3969/j.issn.1673-5374.2013.15.009

• 原著:周围神经损伤修复保护与再生 • 上一篇    下一篇

轻中度腕管综合征不继发尺神经轴索损伤

  

  • 收稿日期:2013-01-10 修回日期:2013-04-03 出版日期:2013-05-25 发布日期:2013-05-25

Axonal degeneration of the ulnar nerve secondary to carpal tunnel syndrome: fact or fiction?

Radwa Mahmoud Azmy, Amira Ahmed Labib, Saly Hassan Elkholy   

  1. Department of Special Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
  • Received:2013-01-10 Revised:2013-04-03 Online:2013-05-25 Published:2013-05-25
  • Contact: Saly Hassan Elkholy, M.D., Professor of clinical neurophysiology, Department of Special Medicine, Faculty of Medicine, Cairo University, 15,106 Street, Maadi 11431, Cairo, Egypt, elkholysaly@yahoo.com.
  • About author:Radwa Mahmoud Azmy☆, M.D., Lecturer of clinical neurophysiology.

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摘要：

感觉症状分布与电生理检测的正中神经损伤程度有关，但腕管综合征与尺神经卡压的关系仍不清楚。为此，我们检测了82例腕管综合征患者尺神经感觉神经传导情况。根据电生理检测结果，将患者分为轻度腕管综合征35例，中度腕管综合征47例。同时纳入61例年龄和性别与之匹配的健康者作为对照。腕管综合征患者尺神经感觉峰值潜伏期和感觉传导速度未受影响，但第4，5指波幅表现出下降趋势，第4/5指波幅比值几乎与对照组相同。轻中度腕管综合征患者出现邻近尺神经纤维机械牵拉的电生理证据，但并未达到真正轴索损伤的程度。

关键词: 神经再生, 周围神经损伤, 腕管综合征, 正中神经, 正中神经损伤症状, 运动传导, 感觉传导, 尺神经, 尺神经波幅比值

Abstract:

The distribution of sensory symptoms in carpal tunnel syndrome is strongly dependent on the degree of electrophysiological dysfunction of the median nerve. The association between carpal tunnel syndrome and ulnar nerve entrapment is still unclear. In this study, we measured ulnar nerve function in 82 patients with carpal tunnel syndrome. The patients were divided into group I with minimal carpal tunnel syndrome (n = 35) and group II with mild to moderate carpal tunnel syndrome (n = 47) according to electrophysiological data. Sixty-one age- and sex-matched subjects without carpal tunnel syndrome were used as a control group. There were no significant differences in ulnar sensory nerve peak latencies or conduction velocities from the 4th and 5th fingers between patients with carpal tunnel syndrome and the control group. The ulnar sensory nerve action potential amplitudes from the 4th and 5th fingers were lower in patients with carpal tunnel syndrome than in the control group. The ratios of the ulnar sensory nerve action potential amplitudes from the 4th and 5th fingers were almost the same in patients with carpal tunnel syndrome as in the control group. These findings indicate that in patients with minimal to moderate carpal tunnel syndrome, there is some electrophysiological evidence of traction on the adjacent ulnar nerve fibers. The findings do not indicate axonal degeneration of the ulnar nerve.

Key words: neural regeneration, peripheral nerve injury, carpal tunnel syndrome, median nerve, extra-median symptoms, motor conduction, sensory conduction, ulnar nerve, ulnar amplitude ratio, neuroregeneration