Han Hye Young, Kim Ha Min, Park So Young, Kim Min-Wook, Kim Jae Min, Jang Dae-Hyun
Department of Rehabilitation Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
GwangGyo Charm and Good Hospital, Yongin, Korea.
Ann Rehabil Med. 2016 Jun;40(3):489-95. doi: 10.5535/arm.2016.40.3.489. Epub 2016 Jun 29.
To evaluate the clinical differences between patients with diabetes mellitus (DM) who have asymptomatic carpal tunnel syndrome (CTS) and those who have symptomatic CTS.
Sixty-three patients with DM were assessed using the Boston Carpal Tunnel Questionnaire (BCTQ), nerve conduction studies (NCS), and ultrasonographic evaluation of the cross-sectional area (CSA) of the median nerve. According to the BCTQ responses and NCS results, the patients were divided into the following three groups: group 1 (n=16), in which NCS results did not reveal CTS; group 2 (n=19), in which NCS results revealed CTS but the group scored 0 points on the BCTQ (asymptomatic); and group 3 (n=28), in which NCS results revealed CTS and the group scored >1 point on the BCTQ (symptomatic). The clinical findings, NCS results, and CSA of the median nerve were compared among the three groups.
There were no significant differences in age, DM duration, glycated hemoglobin levels, and presence of diabetic polyneuropathy among the three groups. The peak latency of the median sensory nerve action potential was significantly shorter in group 1 than in groups 2 and 3 (p<0.001); however, no difference was observed between groups 2 and 3. CSA of the median nerve at the carpal tunnel in group 2 was significantly larger than that in group 1 and smaller than that in group 3 (p<0.05).
The results of our study suggest that the symptoms of CTS in patients with diabetes are related to CSA of the median nerve, which is consistent with swelling of the nerve.
评估无症状腕管综合征（CTS）的糖尿病（DM）患者与有症状CTS的糖尿病患者之间的临床差异。
采用波士顿腕管问卷（BCTQ）、神经传导研究（NCS）以及正中神经横截面积（CSA）的超声评估对63例糖尿病患者进行评估。根据BCTQ回答情况和NCS结果，将患者分为以下三组：第1组（n = 16），NCS结果未显示CTS；第2组（n = 19），NCS结果显示CTS但该组在BCTQ上得0分（无症状）；第3组（n = 28），NCS结果显示CTS且该组在BCTQ上得分>1分（有症状）。比较三组的临床发现、NCS结果以及正中神经的CSA。
三组在年龄、糖尿病病程、糖化血红蛋白水平以及糖尿病性多发性神经病的存在情况方面无显著差异。第1组正中感觉神经动作电位的峰值潜伏期显著短于第2组和第3组（p<0.001）；然而，第2组和第3组之间未观察到差异。第2组腕管处正中神经的CSA显著大于第1组且小于第3组（p<0.05）。
我们的研究结果表明，糖尿病患者CTS的症状与正中神经的CSA有关，这与神经肿胀一致。
