Sheu Jau-Jiuan, Yuan Rey-Yue, Chiou Hung-Yi, Hu Chaur-Jong, Chen Wei-Ta
Department of Neurology, Taipei Medical University Hospital, 252 Wu-Hsing Street, Taipei, Taiwan, ROC.
Clin Neurophysiol. 2006 Jun;117(6):1249-55. doi: 10.1016/j.clinph.2006.02.004. Epub 2006 Apr 4.
The aims of this study were to analyze normative data of nerve conduction studies (NCS) by optimal transformations, and compare the utility of electrodiagnostic tests in detecting mild carpal tunnel syndrome (CTS).
In 131 hands of patients with mild CTS and 136 hands of controls, the segmental study of the median nerve between the digit-palm and palm-wrist segments, and the median-to-ulnar and median-to-radial comparative tests were performed. Normal limits were derived by calculating the mean+/-2 standard deviations of the optimally transformed data of the controls. The specificity, sensitivity, and misclassification rate were calculated to evaluate the utility of each test.
All tests had high specificities, ranging from 98.5 to 100%. The distoproximal latency ratio (DPLR) of the median nerve showed the highest sensitivity and the difference between the median and radial sensory latencies (D1M-D1R) the second highest, but there was no statistical difference between them. The difference between the median and ulnar mixed nerve latencies in the palm-to-wrist segment (PM-PU) showed the lowest sensitivity. Misclassification rates of the DPLR, D1M-D1R, and PM-PU were 6.9, 3.8, and 6.1%, respectively.
Optimal transformation of NCS data is mandatory to diminish the effect of skewness and enhance the diagnostic accuracy. As compared to the comparative tests, the segmental study of the median nerve is more easily applied and yields higher sensitivity in detecting mild CTS.
With a high diagnostic yield and easy application, the segmental study of the median nerve may routinely be used to evaluate patients with mild CTS.
本研究旨在通过优化转换分析神经传导研究（NCS）的标准数据，并比较电诊断测试在检测轻度腕管综合征（CTS）中的效用。
对131例轻度CTS患者的手和136例对照者的手进行了研究，对指-掌段和掌-腕段的正中神经进行节段性研究，并进行正中神经与尺神经、正中神经与桡神经的对比测试。通过计算对照者优化转换数据的均值±2标准差得出正常范围。计算特异性、敏感性和错误分类率以评估每项测试的效用。
所有测试均具有较高的特异性，范围为98.5%至100%。正中神经的远端-近端潜伏期比值（DPLR）显示出最高的敏感性，正中神经与桡神经感觉潜伏期之差（D1M-D1R）次之，但两者之间无统计学差异。掌-腕段正中神经与尺神经混合神经潜伏期之差（PM-PU）显示出最低的敏感性。DPLR、D1M-D1R和PM-PU的错误分类率分别为6.9%、3.8%和6.1%。
NCS数据的优化转换对于减少偏态影响和提高诊断准确性是必不可少的。与对比测试相比，正中神经节段性研究更易于应用，并且在检测轻度CTS时具有更高的敏感性。
正中神经节段性研究具有较高的诊断率且易于应用，可常规用于评估轻度CTS患者。
