感觉性多发性神经病患者的腓肠神经和桡神经感觉反应
Sural and Radial Sensory Responses in Patients with Sensory Polyneuropathy.
作者信息
Guo Ying, Palmer J Lynn, Brown Xun S, Fu Jack B
机构信息
Department of Palliative Care & Rehabilitation Medicine, University of Texas MD Anderson Cancer Center.
Department of Biostatistics, University of Texas MD Anderson Cancer Center.
出版信息
Clin Med Rev Case Rep. 2015;2(3). doi: 10.23937/2378-3656/1410049. Epub 2015 Aug 21.
INTRODUCTION
The sural/radial nerve amplitude ratio (SRAR) is the quotient of the sensory nerve action potential (SNAP) amplitudes (Amp) of the sural and the superficial radial nerve. It has been hypothesized that this ratio can be used for the detection of early axonal loss, because the sural SNAP amplitude will decrease first, thereby also decreasing the SRAR value.
OBJECTIVES
To determine the sensitivity and specificity of SRAR, age-adjusted sural and radial SNAP Amp in the diagnosis of axonal sensory polyneuropathy in cancer patients.
DESIGN
Retrospective review.
SETTING
Comprehensive cancer center.
PATIENTS
One hundred and ninety one EMG reports from January 2001 to December 2005.
METHODS
The independent variable is the diagnosis of axonal sensory polyneuropathy in the EMG reports that is based on multiple tests.
MAIN OUTCOME MEASUREMENTS
We assessed the agreement between classifications of axonal sensory polyneuropathy made using the current 'gold standard' and the proposed method that is based on patients' age-adjusted radial and sural SNAP amplitude; an SRAR being above or below the normal value (0.21).
RESULTS
We found that the sensitivities for age-adjusted radial SNAP Amp, age-adjusted sural SNAP Amp, and SRAR were 33%, 64%, 56% respectively; the specificities were 85%, 70%, 77% respectively.
CONCLUSIONS
SRAR is neither the most sensitive, nor the most specific in the diagnosis of axonal sensory polyneuropathy.
引言
腓肠神经/桡神经振幅比（SRAR）是腓肠神经和桡浅神经的感觉神经动作电位（SNAP）振幅的商。据推测，该比值可用于检测早期轴突损失，因为腓肠神经SNAP振幅会首先降低，从而也会降低SRAR值。
目的
确定SRAR、年龄校正后的腓肠神经和桡神经SNAP振幅在诊断癌症患者轴索性感觉性多发性神经病中的敏感性和特异性。
设计
回顾性研究。
地点
综合癌症中心。
患者
2001年1月至2005年12月的191份肌电图报告。
方法
自变量是基于多项检查的肌电图报告中轴索性感觉性多发性神经病的诊断。
主要观察指标
我们评估了使用当前“金标准”进行的轴索性感觉性多发性神经病分类与基于患者年龄校正后的桡神经和腓肠神经SNAP振幅的提议方法之间的一致性；SRAR高于或低于正常值（0.21）。
结果
我们发现年龄校正后的桡神经SNAP振幅、年龄校正后的腓肠神经SNAP振幅和SRAR的敏感性分别为33%、64%、56%；特异性分别为85%、70%、77%。
结论
在轴索性感觉性多发性神经病的诊断中，SRAR既不是最敏感的，也不是最特异的。
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