Department of Physical Medicine and Rehabilitation, Korea University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2011 Sep;26(9):1227-30. doi: 10.3346/jkms.2011.26.9.1227. Epub 2011 Sep 1.
This study was designed to identify the causes of the development of carpal tunnel syndrome (CTS) associated with end stage kidney disease (ESKD). A total of 112 patients with ESKD, 64 on hemodialysis (HD) and 48 on peritoneal dialysis (PD), were enrolled. The duration of ESKD and dialysis, the site of the arteriovenous (A-V) fistula for HD, laboratory data such as blood urea nitrogen, creatinine, and beta-2-microglobulin were determined. Clinical evaluation of CTS and electrophysiological studies for the diagnosis of CTS and peripheral neuropathy were performed. The electrophysiological studies showed that the frequency of CTS was not different in the HD and PD groups (P = 0.823) and the frequency of CTS was not different in the limb with the A-V fistula compared to the contralateral limb (P = 0.816). The frequency of HD and PD were not related to beta-2-microglobulin levels, an indicator of amyloidosis. The frequency of CTS did not increase as the severity of the peripheral neuropathy and the duration of ESKD and dialysis increased (P = 0.307). The results of this study do not support that microglobulin induced amyloidosis or placement of an A-V fistula are associated with an increase in CTS.
本研究旨在确定与终末期肾病（ESKD）相关的腕管综合征（CTS）的发展原因。共纳入 112 名 ESKD 患者，其中 64 名接受血液透析（HD），48 名接受腹膜透析（PD）。确定 ESKD 和透析的持续时间、用于 HD 的动静脉（A-V）瘘的部位、血液尿素氮、肌酐和β-2-微球蛋白等实验室数据。进行 CTS 的临床评估和用于诊断 CTS 和周围神经病的电生理研究。电生理研究表明，HD 和 PD 组的 CTS 发生率无差异（P=0.823），且与对侧肢体相比，A-V 瘘侧的 CTS 发生率无差异（P=0.816）。HD 和 PD 的发生率与β-2-微球蛋白水平（淀粉样变性的指标）无关。CTS 的发生率并未随着周围神经病的严重程度以及 ESKD 和透析的持续时间的增加而增加（P=0.307）。本研究的结果不支持微球蛋白诱导的淀粉样变性或 A-V 瘘的放置与 CTS 发生率增加有关。
