Wei J, Tian L, Zhang Z C, Wang H Z, Liu N, Sun X H
The Third Central Clinical College of Tianjin Medical University, Tianjin 300170, China;Department of Senior Ward, Tianjin Third Central Hospital, Tianjin 300170, China; Tianjin Key Laboratory of Artificial Cell, Artificial Cell Engineering Technology Research Center of Public Health Ministry, Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China.
Department of Neurology, Tianjin Third Central Hospital, Tianjin 300170, China; Tianjin Key Laboratory of Artificial Cell, Artificial Cell Engineering Technology Research Center of Public Health Ministry, Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2019 Jan 20;37(1):30-33. doi: 10.3760/cma.j.issn.1001-9391.2019.01.006.
To evaluate the severity of median nerve damage in patients with carpal tunnel syndrome (CTS) , and to analyze its relationship with body mass index (BMI) and wrist joint index. From May 2016 to January 2017, 23 patients with mild CTS (mild group) and 35 patients with moderate to severe CTS (moderate to severe group) were enrolled in this study. And 22 healthy volunteers matched for sex and age were selected as control group. The neuroelectrophysiological monitor was used to measure the median nerve movement and sensory nerve conduction in the subjects. The BMI and wrist joint index were calculated. The relationship of neuroelectrophysiological parameters with BMI and wrist joint index was analyzed in the CTS patients. Compared with the control group, the mild group and the moderate to severe group had significantly higher wrist joint index, significantly longer distal motor latency (DML) of the median nerve, and significantly lower sensory nerve conduction velocity (SNCV) and sensory nerve action potential (SNAP) amplitude of the finger 1wrist and finger 3wrist (<0.01) ; the moderate to severe group had significantly higher BMI and significantly lower composite muscle action potential (CMAP) amplitude (<0.01) . The wrist joint index and BMI were positively correlated with DML of the median nerve and negatively correlated with SCV and SNAP amplitude of the finger 1wrist and finger 3wrist (all <0.05) . The patients with a wrist joint index of >0.73 had a significantly higher risk of CTS than those with a wrist joint index of <0.73 (odd ratio=30.67, 95% confidence interval: 3.79-248.36) . A wrist joint index of >0.73 is an independent risk factor for CTS in manual laborers. CTS should be prevented in the manual laborers with high wrist joint index and BMI.
评估腕管综合征（CTS）患者正中神经损伤的严重程度，并分析其与体重指数（BMI）和腕关节指数的关系。2016年5月至2017年1月，本研究纳入了23例轻度CTS患者（轻度组）和35例中重度CTS患者（中重度组）。选取22名年龄和性别匹配的健康志愿者作为对照组。使用神经电生理监测仪测量受试者正中神经运动和感觉神经传导情况。计算BMI和腕关节指数。分析CTS患者神经电生理参数与BMI和腕关节指数的关系。与对照组相比，轻度组和中重度组的腕关节指数显著更高，正中神经的远端运动潜伏期（DML）显著更长，手指1-腕部和手指3-腕部的感觉神经传导速度（SNCV）和感觉神经动作电位（SNAP）波幅显著更低（<0.01）；中重度组的BMI显著更高，复合肌肉动作电位（CMAP）波幅显著更低（<0.01）。腕关节指数和BMI与正中神经的DML呈正相关，与手指1-腕部和手指3-腕部的SCV和SNAP波幅呈负相关（均<0.05）。腕关节指数>0.73的患者患CTS的风险显著高于腕关节指数<0.73的患者（比值比=30.67，95%置信区间：3.79-248.36）。腕关节指数>0.73是体力劳动者患CTS的独立危险因素。对于腕关节指数和BMI较高的体力劳动者，应预防CTS。
