Franzblau A, Werner R A, Johnston E, Torrey S
Department of Environmental and Industrial Health, University of Michigan School of Public Health, Ann Arbor 48109-2029.
J Occup Med. 1994 Sep;36(9):1015-21.
Eighty-four workers participated in a work-site screening program designed, in part, to estimate the prevalence of carpal tunnel syndrome (CTS). Each worker completed a discomfort survey, limited electrodiagnostic testing of the median and ulnar sensory nerves in each wrist, and current perception threshold (CPT) testing in the right 2nd digit using the NEUROMETER CPT device. A subset of study participants also completed CPT testing in digit 5 on the right (n = 33). Comparisons were made among the CPT results, symptoms consistent with CTS, and electrophysiologic findings. The CPT results correlated poorly with electrophysiologic parameters from the same nerve distribution, and CPT results were statistically unrelated to self-reported symptoms that may be suggestive of CTS. The test performance characteristics of CPT testing (sensitivity, specificity, positive predictive value, and negative predictive value) were low in comparison with electrodiagnostic measurements and self-reported symptoms consistent with CTS. The electrophysiologic results were significantly associated with the constellation of symptoms that are consistent with CTS. On the basis of these results, CPT testing cannot be recommended as a screening procedure for identification of possible cases of CTS among active industrial workers.
84名工人参与了一项工作场所筛查项目，该项目部分旨在估计腕管综合征（CTS）的患病率。每位工人都完成了一份不适调查问卷、对每只手腕的正中神经和尺神经进行了有限的电诊断测试，以及使用神经仪CPT设备对右手食指进行了电流感觉阈值（CPT）测试。一部分研究参与者还对右手小指进行了CPT测试（n = 33）。对CPT结果、与CTS相符的症状以及电生理结果进行了比较。CPT结果与来自相同神经分布的电生理参数相关性较差，且CPT结果与可能提示CTS的自我报告症状在统计学上无关。与电诊断测量以及与CTS相符的自我报告症状相比，CPT测试的性能特征（敏感性、特异性、阳性预测值和阴性预测值）较低。电生理结果与与CTS相符的一系列症状显著相关。基于这些结果，不建议将CPT测试作为在在职产业工人中识别可能患有CTS病例的筛查程序。
