Seror P
Laboratoire d'éléctromyographie, 146 Avenue Ledru Rollin, 75011 Paris, France.
Muscle Nerve. 2001 Dec;24(12):1595-600. doi: 10.1002/mus.1193.
This prospective study was undertaken to determine the clinical relevance, reliability, sensitivity, and specificity of the orthodromic inching test with 2-cm incremental study of the median nerve over the four intracarpal centimeters in 50 control and 50 successive (unselected) patient wrists with mild carpal tunnel syndrome (CTS). In controls, the mean maximum conduction delay per 2 cm (CD/2cm) was 0.445 +/- 0.04 ms, and abnormality was defined as at least one CD/2cm exceeding the mean + 2.5 SD of the normal CD/2cm. This yielded a specificity of 98%. In patients with mild unselected CTS, this simplified orthodromic inching test (SOIT) detected the median nerve lesion at the wrist in 47 cases (sensitivity = 94%). The SOIT detected 15 more CTS cases than did the orthodromic median-ulnar latency difference of the 4th digit (Chi square = 13; P =.002). Thus, the SOIT was as effective as an incremental study every centimeter over 10 cm, and the time required for the test allows its routine use when other electrodiagnostic tests fail to reveal any median nerve impairment.
本前瞻性研究旨在确定在50名对照者和50例连续（未筛选）的轻度腕管综合征（CTS）患者手腕中，对正中神经在腕内4厘米范围内进行2厘米增量研究的顺行性微移试验的临床相关性、可靠性、敏感性和特异性。在对照者中，每2厘米的平均最大传导延迟（CD/2cm）为0.445±0.04毫秒，异常定义为至少有一个CD/2cm超过正常CD/2cm的平均值+2.5标准差。这产生了98%的特异性。在未筛选的轻度CTS患者中，这种简化的顺行性微移试验（SOIT）在47例中检测到手腕处的正中神经病变（敏感性=94%）。SOIT比第四指的正中-尺侧潜伏期差异检测到的CTS病例多15例（卡方检验=13；P=0.002）。因此，SOIT与对正中神经在10厘米范围内每厘米进行增量研究的效果相同，并且该试验所需的时间使其在其他电诊断试验未能发现任何正中神经损伤时可常规使用。
