F波逆转在腕管综合征诊断中的价值

The value of F-wave inversion in the diagnosis of carpal tunnel syndrome

目的探讨F波逆转在腕管综合征诊断中的价值。方法选取2011年7月至2015年6月于本院康复科电生理室明确诊断为腕管综合征的171例患者(观察组)与神经传导、神经电图及肌电图检查未见异常者48例(对照组)为研究对象。分析两组患者正中神经与同侧尺神经F波平均潜伏期及其差值变化情况、正中神经远端M波潜伏期与F波平均潜伏期之比(M/F百分比)及其接受者操作特征曲线(receiver operating characteristic curve,ROC曲线)、F波逆转出现肢体数、出现F波逆转者同侧尺神经与正中神经F波潜伏期差值与性别、年龄、身高的相关性。结果观察组患者患侧正中神经F波平均潜伏期显著长于对照组(t=11.24,P<0.01);同侧尺神经F波平均潜伏期组间比较无显著差异(t=1.01,P>0.05);正中神经M/F百分比、同侧尺神经与正中神经F波潜伏期差值组间比较均具有显著差异(t=10.09,P<0.01;t=10.01,P<0.01)。观察组患者正中神经出现F波逆转肢体数为182个,对照组为12个,差异具有显著性(Mc Nemar检验:χ~2=5.03,P<0.05;Kappa=0.64)。两组患者正中神经M/F百分比ROC曲线显示:M/F百分比为14.06%时,约登指数为最大值0.70。F波逆转受检者的194对同侧尺神经与正中神经F波潜伏期差值与研究人群性别、年龄、身高均无显著相关性(P>0.05)。结论正中神经F波逆转可以作为腕管综合征诊断依据之一。

ObjectiveTo investigate the value of F-wave inversion in the diagnosis of carpal tunnel syndrome. MethodFrom July 2011 to June 2015, 171 cases of carpal tunnel syndrome patients （observation group） and 48 cases of electrophysiological examination no abnormalities （control group） diagnosed in our hospital were selected as the subjects. The average latency of F-wave and its di？erence between the median nerve and the ipsilateral ulnar nerve, median nerve M/F% and the receiver operating characteristic curve （ROC） curve, limb numbers of F-wave inversion, the correlation between F-wave Latency di？erence （ipsilateral ulnar nerve and median nerve） and gender, age and height of subjects who have F-wave inversion were analyzed. ResultThe average latency of the median nerve F-waves in observation group was signi？cantly longer than control group （t = 11.24, P 〈 0.01）. There was no signi？cant di？erence between the two groups about the average latency of the ipsilateral ulnar nerve F-wave （t = 1.01, P 〉 0.05）. The median nerve M/F% and the latency di？erence between ipsilateral ulnar nerve and median nerve F-wave were signi？cant between the two groups （t = 10.09, P 〈 0.01; t = 10.01, P 〈 0.01）. Median nerve F-INV limb number observation group was 182, control group was 12, there was a signi？cant di？erences between the two groups （McNemar test： χ2=5.03, P〈0.05; Kappa=0.64）. The ROC curve of median nerve M/F% in the two groups showed that youden index was 0.70 when the percentage of M/F% was 14.06%. There was no signi？cant correlation between F-wave latency di？erence （194 ipsilateral ulnar nerve and median nerve） and gender, age and height of subjects who have F-wave inversion （P〉0.05）. ConclusionThe F-wave inversion of median nerve can be used as a basis for the diagnosis of carpal tunnel syndrome.