平山病和肌萎缩侧索硬化症中的裂手指数与尺侧/正中神经比值
Split hand index and ulnar to median ratio in Hirayama disease and amyotrophic lateral sclerosis.
作者信息
Kalita Jayantee, Kumar Surendra, Misra Usha K, Neyaz Zafar
机构信息
a Department of Neurology , Sanjay Gandhi Post Graduate Institute of Medical Sciences , Lucknow , UP , India and.
b Department of Radio diagnosis , Sanjay Gandhi Post Graduate Institute of Medical Sciences , Lucknow , UP , India.
出版信息
Amyotroph Lateral Scler Frontotemporal Degener. 2017 Nov;18(7-8):598-603. doi: 10.1080/21678421.2017.1336561. Epub 2017 Jun 15.
OBJECTIVE
We report the relative usefulness of split hand index (SHI) and ulnar to median (UM) ratio in Hirayama disease (HD) and amyotrophic lateral sclerosis (ALS).
METHODS
The patients with HD, ALS and matched controls were subjected to evaluation of UM ratio and SHI. Compound muscle action potentials (CMAPs) were recorded from abductor digit minimi (ADM) and first dorsal interosseous (FDI) by stimulating ulnar nerve at the wrist, and abductor pollicis brevis (APB) by stimulating median nerve at the wrist. UM ratio (ADM/APB) and SHI (APB × FDI/ADM) were calculated, and compared. Sensitivity and specificity of SHI and UM ratio in HD and ALS were calculated.
RESULTS
Twenty-six HD and 31 ALS patients were included. Twenty-six matched controls for HD and 20 for ALS were also evaluated. The APB amplitude was significantly lower in ALS compared to HD (6.89 ± 2.0 mv vs. 2.13 ± 1.27 mv, p = 0.01). UM ratio <0.86 had a sensitivity of 80.4% and specificity of 86.3% for HD. SH1 ≤ 5.2 had a sensitivity of 82% and specificity of 88.8% for ALS. UM ratio had a poor specificity for ALS (18.9%) and SHI for HD (34%).
CONCLUSION
UM ratio is more sensitive and specific for HD and SHI for ALS patients.
目的
我们报告了劈手指数（SHI）和尺神经与正中神经比值（UM）在平山病（HD）和肌萎缩侧索硬化症（ALS）中的相对实用性。
方法
对HD、ALS患者及匹配的对照组进行UM比值和SHI评估。通过在腕部刺激尺神经，记录小指展肌（ADM）和第一背侧骨间肌（FDI）的复合肌肉动作电位（CMAP），并通过在腕部刺激正中神经记录拇短展肌（APB）的CMAP。计算并比较UM比值（ADM/APB）和SHI（APB×FDI/ADM）。计算SHI和UM比值在HD和ALS中的敏感性和特异性。
结果
纳入了26例HD患者和31例ALS患者。还评估了26例HD匹配对照组和20例ALS匹配对照组。与HD相比，ALS患者的APB波幅显著更低（6.89±2.0mV对2.13±1.27mV，p = 0.01）。UM比值<0.86对HD的敏感性为80.4%，特异性为86.3%。SH1≤5.2对ALS的敏感性为82%，特异性为88.8%。UM比值对ALS的特异性较差（18.9%），SHI对HD的特异性较差（34%）。
结论
UM比值对HD患者更敏感且更具特异性，而SHI对ALS患者更敏感且更具特异性。
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