腕管综合征患者的腕部比率及腕掌指数研究
Study of Wrist Ratio and Wrist-to-Palm Index Radio in Individuals Suffering from Carpal Tunnel Syndrome.
作者信息
Palve Suchitra Sachin, Palve Sachin Bhaskar
机构信息
Department of Physiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji vidyapeeth (Deemed to be University) Puducherry, India.
Department of Community Medicine, Mahatma Gandhi Medical College and Research Institute, Sri Balaji vidyapeeth (Deemed to be University) Puducherry, India.
出版信息
Ann Indian Acad Neurol. 2019 Apr-Jun;22(2):159-163. doi: 10.4103/aian.AIAN_343_18.
BACKGROUND
Carpal tunnel syndrome (CTS) is the commonest median nerve entrapment neuropathy, with preponderance in females.
AIMS AND OBJECTIVE
The aim of the present study was to find out wrist ratio (WR) and wrist/palm ratio (WPR) in clinically diagnosed patients of CTS.
METHODOLOGY
One hundred individuals (fifty patients of CTS and fifty as control group) aged between 30 and 50 years were recruited for the study. Early confirmation of clinically suspected patients of CTS was done by performing electrodiagnostic tests of median and ulnar nerves. Motor and sensory conduction velocities, distal motor and sensory latencies, and F-wave latencies were performed in the recruited volunteers.
RESULTS
The values for mean wrist ratio in control groups were 0.694, 0.703 respectively, and in patients with carpal tunnel syndrome, it was 0.704 and 0.719 respectively in moderate and severe type. The mean wrist to palm ratio (WPR) in control group was 0.371, while in patients with CTS, it was 0.374, 0.382, 0.387, and 0.401 based on progression of severity. Both were statistically significant for the last two groups (wrist to index finger [WIF] >4.4 m/s, moderate, and WIF nonrecordable, severe). Statistically significant ( < 0.001) decrease of motor conduction velocities for median nerve was seen in the CTS group as compared to control group. Statistically significant ( < 0.001) increase in distal motor and sensory latencies was observed for both median and ulnar nerves in CTS group with more increase in distal motor latency than sensory latency. Increase in F-wave latencies of both nerves was seen in CTS group.
CONCLUSION
The study results confirm selective slowing of sensory and motor conduction within wrist-to-palm segment in patients of CTS. Both WR and WPR have a progressive correlation with the severity of CTS, but statistically significant changes were seen in the groups with moderate and severe CTS. Thus, WR/WPR can act as one of the essential parameters in the diagnosis of CTS with moderate-to-severe CTS.
背景
腕管综合征（CTS）是最常见的正中神经卡压性神经病，女性更为多见。
目的
本研究的目的是找出临床诊断为腕管综合征患者的腕比（WR）和腕/掌比（WPR）。
方法
招募了100名年龄在30至50岁之间的个体（50名腕管综合征患者和50名作为对照组）进行研究。通过对正中神经和尺神经进行电诊断测试，对临床疑似腕管综合征患者进行早期确诊。对招募的志愿者进行运动和感觉传导速度、远端运动和感觉潜伏期以及F波潜伏期的检测。
结果
对照组的平均腕比分别为0.694、0.703，而在腕管综合征患者中，中度和重度类型的平均腕比分别为0.704和0.719。对照组的平均腕掌比（WPR）为0.371，而在腕管综合征患者中，根据严重程度的进展，其值分别为0.374、0.382、0.387和0.401。后两组（腕-食指[WIF]>4.4 m/s，中度，以及WIF不可记录，重度）在这两个指标上均具有统计学意义。与对照组相比，腕管综合征组正中神经的运动传导速度有统计学意义（<0.001）的下降。腕管综合征组正中神经和尺神经的远端运动和感觉潜伏期均有统计学意义（<0.001）的增加，且远端运动潜伏期的增加幅度大于感觉潜伏期。腕管综合征组两条神经的F波潜伏期均增加。
结论
研究结果证实了腕管综合征患者腕掌段内感觉和运动传导的选择性减慢。WR和WPR均与腕管综合征的严重程度呈渐进性相关，但在中度和重度腕管综合征组中出现了统计学意义的变化。因此，WR/WPR可作为诊断中度至重度腕管综合征的重要参数之一。
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