中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2015, Vol. 10 ›› Issue (7): 1172-1176.doi: :10.4103/1673-5374.160117

• 原著:周围神经损伤修复保护与再生 • 上一篇    

腕管入口与出口正中神经横截面积比值能反映腕管综合征的严重程度？

  

  • 收稿日期:2015-04-06 出版日期:2015-07-24 发布日期:2015-07-24
  • 基金资助:

    973计划(2014CB542201)

Does the ratio of the carpal tunnel inlet and outlet cross-sectional areas in the median nerve reflect carpal tunnel syndrome severity?

Li Zhang 1, 2, 3, Aierken Rehemutula 1, 2, 3, Feng Peng 1, 2, 3,  Cong Yu 1, 2, 3, Tian-bin Wang 4, Lin Chen 1, 2, 3   

  1. 1 Department of Hand Surgery, Huashan Hospital, Fudan University, Shanghai, China
    2 Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China
    3 Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China
    4 Department of Orthopedics, Beijing University People’s Hospital, Beijing, China
  • Received:2015-04-06 Online:2015-07-24 Published:2015-07-24
  • Contact: Feng Peng, M.D., peng_f@163.com.
  • Supported by:

     This study was supported by a grant from the Shanghai Key Laboratory of Peripheral Nerve and Microsurgery in China, No. 14DZ2273300; the Natural Science Foundation of Shanghai in China, No. 13ZR1404600; and a grant from the National Key Basic Research Program of China (973 Program), No. 2014CB542201.

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摘要：

对腕管综合征既往研究中选择的超声检测指标往往仅反映了正中神经的一个病变部位，但具体哪些超声检测指标能准确反映腕管综合征的严重程度？由于腕管入口、出口处正中神经横截面积是反映腕部正中神经肿胀处及卡压部位的超声指标，我们假设通过计算二者的比值能准确反映腕管综合征的严重程度。为此，实验设计对77例腕管综合征患者采用腕部高频(5-17 MHz)超声检测，发现腕管入口与出口处正中神经横截面积比值的临界值为1.14。轻、中、重度腕管综合征患者的腕管入口与出口处正中神经横截面积比值均差异明显。其中轻度和中重度腕管综合征患者的正中神经横截面积比值临界值为1.29，敏感性和特异性分别为64.7%和72.7%；中度和重度腕管综合征患者正中神经横截面积比值临界值为1.52，敏感性和特异性分别为80.0%和64.7%。结果说明腕管入口与出口正中神经横截面积比值可能反映腕管综合征的严重程度。

关键词: 神经再生, 周围神经损伤, 超声检查, 腕管综合征, 诊断, 横截面积, 分类, 临床实验室技术, 正中神经, 电生理检查, 973计划

Abstract:

Although ultrasound measurements have been used in previous studies on carpal tunnel syndrome to visualize injury to the median nerve, whether such ultrasound data can indicate the severity of carpal tunnel syndrome remains controversial. The cross-sectional areas of the median nerve at the tunnel inlet and outlet can show swelling and compression of the nerve at the carpal. We hypothesized that the ratio of the cross-sectional areas of the median nerve at the carpal tunnel inlet to outlet accurately reflects the severity of carpal tunnel syndrome. To test this, high-resolution ultrasound with a linear array transducer at 5–17 MHz was used to assess 77 patients with carpal tunnel syndrome. The results showed that the cut-off point for the inlet-to-outlet ratio was 1.14. Significant differences in the inlet-to-outlet ratio were found among patients with mild, moderate, and severe carpal tunnel syndrome. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.29 between mild and more severe (moderate and severe) carpal tunnel syndrome patients with 64.7% sensitivity and 72.7% specificity. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.52 between the moderate and severe carpal tunnel syndrome patients with 80.0% sensitivity and 64.7% specificity. These results suggest that the inlet-to-outlet ratio reflected the severity of carpal tunnel syndrome.

Key words: nerve regeneration, peripheral nerve injury, ultrasonography, carpal tunnel syndrome, diagnosis, cross-sectional area, classification, clinical laboratory technique, electrodiagnosis, median nerve, 973 Program, neural regeneration