骨间前神经卡压征的电生理研究

A electrophysiological study of the anterior interosseous nerve entrapment syndrome

目的分析总结骨间前神经卡压征的神经电生理特点，探讨其对骨间前神经卡压征的诊断意义。方法对12例骨间前神经卡压征患者进行神经电生理检测：（1）惠侧及对侧骨间前神经运动潜伏期及复合肌肉动作电位波幅：（2）患侧正中神经运动、感觉传导速度及复合肌肉动作电位、感觉动作电位波幅：（3）患侧拇短展肌、指浅屈肌、旋前方肌、拇长屈肌肌电图。结果10例骨间前神经运动潜伏期延长；12例骨间前神经复合肌肉动作电位波幅降低；12例正中神经运动、感觉传导速度及复合肌肉动作电位、感觉动作电位波幅正常：12例旋前方肌、10例拇长屈肌肌电图示神经性损害；12例拇短展肌、指浅屈肌肌电图正常。结论骨间前神经卡压征的神经电生理表现特点为：骨间前神经运动传导潜伏期延长及复合肌肉动作电位波幅降低，其支配肌肉肌电图示神经性损害，而正中神经运动及感觉传导正常．其支配肌肉肌电图正常。骨间前神经卡压征的神经电生理表现可为该病提供客观、准确的诊断与鉴别诊断依据。

Objective To investigate the clinical and electrophysiological characteristics of the anterior interosseous nerve entrapment syndrome. Methods Twelve cases （8 male,4 female, mean age 35.8） of anterior interosseous nerve entrapment syndrome were involved in this study. Motor latency （ML） of the anterior interosseous nerve, motor and sensory conduction velocity （MCV, SCV）of median nerve and electromyography （EMG）of abductor pollicis brevis, flexor digitorum superficialis, quadrate pronator muscle, flexor pollicis longus were conducted in all cases. Results Prolongation of the ML of the anterior interosseous nerve was detected in 10 cases; amplitude of the compound muscle action potential（CMAP） of the anterior interosseous nerve was reduced in 12 cases; MCV and the amplitude of CMAP of median nerve, SCV and the amplitude of the sensory nerve action potential（SNAP） of median nerve were normal in all 12 cases; EMG of quadrate pronator muscle in 12 cases and of flexor pollicis longus in 10 cases displayed neurogenic lesions; EMG of abductor pollicis brevis and flexor digitorum superficialis were normal in 12 cases. Conclusion The electrophysiological features of the anterior interosseous nerve entrapment syndrome were protraction of the ML, decreased amplitude of CMAP of the anterior interosseous nerve, neurogenic lesions in EMG, and normal value of MCV and CMAP of median nerve and SCV.Electrophysiological examination could provide objective and distinguish diagnostic basis for the anterior interosseous nerve entrapment syndrome.