天津医药

• 短篇论著 •    

腕管综合征运动纤维损害的早期电诊断评价

郑丽娜1,张哲成2,刘娜2,田丽2,朱炬2,张静2   

  1. 1. 天津医科大学三中心临床学院
    2. 天津市第三中心医院神经内科
  • 收稿日期:2012-09-19 修回日期:2013-02-17 出版日期:2013-07-15 发布日期:2013-07-15
  • 通讯作者: 郑丽娜

Early Evaluation of Electrical Diagnostics of Motor Nerve Damage in Carpal Tunnel Syndrome

ZHANG ZHECHENG 2,LIU NA 3,TIAN QIAN 3,ZHUJu 2,ZHANG JING 2   

  • Received:2012-09-19 Revised:2013-02-17 Published:2013-07-15 Online:2013-07-15

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摘要：

【 摘要】 目的 研究运动单位数目估计(MUNE)、 运动单位动作电位(MUAP)时限及波幅和复合肌肉动作电位(CMAP)波幅对腕管综合征(CTS)运动轴索损害的早期评价作用。 方法 选取40例 CTS 患者， 其中 CMAP波幅正常组、异常组各 20 例， 选取同期健康体检者 20 例为对照组； 应用 Keypoint.net肌电图仪于拇短展肌记录 MUNE、MUAP时限及波幅。 结果 CTS患者较对照组 MUNE 减少， MUAP时限增宽， 波幅增高 (均 P < 0.05)。 CMAP波幅正常组较对照组MUNE 降低 (142.85±21.51 vs 188.23±23.51, P < 0.05)， MUAP时限增宽（12.83±1.39 ms vs 10.19±1.28 ms,P < 0.05)， 波幅增高（959.60±92.41 μV vs 789.45±70.74 μV, P < 0.05）。 MUNE、MUAP时限及波幅对 CTS 运动轴索损害的诊断均有较好的准确性， 其ROC 曲线下面积分别为 0.934、0.919、0.921。 结论 MUNE、MUAP时限及波幅可早期评价CTS运动纤维的轴索功能。


关键词: 腕管综合征, ROC曲线, 运动单位数目估计, 运动单位动作电位, 复合肌肉动作电位

Abstract: Abstract   Objective   To early evaluate the function status of motor fibers in patients with carpal tunnel sydrome (CTS) according to the number of motor units estimated (MUNE), the duration and amplitude of motor unit action potential (MUAP) and the amplitude of compound muscle action potential (CMAP). Methods   We evaluated 40 patients, who had been diagnosed with CTS. There were 20 patients in CMAP normal group and 20 patients in CMAP abnormal group. The control group includes 20 healthy people. We used the Keypoint.net(Medoc Ltd)electromyogram device to record the MUNE，the duration and amplitude of motor unit action potential (MUAP) of the abductor pollicis brevis. Results  The MUNE reduced, the MUAP duration prolonged and amplitude highed in the CTS group, There were significantly different from those found in the control group (P<0.05). In CMAP normal group and control group the MUNE was 142.85±21.51 vs 188.23±23.51,(P<0.05), the duration of MUAP was 12.83±1.39ms vs 10.19±1.28ms,(P<0.05)and amplitude 959.60±92.41μV vs 789.45±70.74μV,(P<0.05). The area under the ROC curve was 0.934 for MUNE, 0.919 for MUAP duration and 0.921 for MUAP amplitude. Conclusion   The MUNE ,the duration and amplitude of the MUAP could early evaluate the function status of motor fibers in patients with CTS compared with the CMAP .

Key words: carpal tunnel syndrome, ROC curves, motor unit number estimation, motor unit action potential, compound muscle action potential