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| 肌电图检查评估糖尿病对腕管综合征的影响 |
| Electrodiagnostic evaluation of diabetes on carpal tunnel syndrome |
| 投稿时间：2023-12-04 修订日期：2023-12-04 |
| DOI： |
| 中文关键词: 糖尿病 腕管综合征 神经电生理 |
| 英文关键词: diabetic mellitus carpal tunnel syndrome electrodiagnostic |
| 基金项目:“揣穴促通”电针法结合表面肌电图治疗面神经炎随机对照研究 |
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| 中文摘要: |
| 目的 研究在糖尿病（Diabetes Mellitus，DM）患者与普通人群中初诊腕管综合征（carpal tunnel syndrome，CTS）的电生理学差异，评估DM对CTS的影响。方法 选取2022年4月至2023年2月因间断手麻至我院就诊并首次确诊为CTS的患者共59例，健康体检人群32例。根据其病史分为CTS组、DM+CTS组，另以健康体检人群为对照组。三组均接受电生理检查，观察正中神经和尺神经运动传导的远端潜伏期（DML）、传导速度（MNCV）、波幅（CMAP）等，正中神经拇指-腕、食指-腕、中指-腕、腕-肘及尺神经小指-腕的感觉神经传导的传导速度（SNCV）和波幅（SNAP）等，比较各组电生理检查结果。结果 DM+CTS组的严重程度显著重于单纯CTS组（Z=2.762，P=0.0057）。DM+CTS组与CTS组的正中神经的运动传导DML延长、CMAP波幅减小，感觉传导的中指-腕、食指-腕、拇指-腕SNCV减慢，SNAP波幅减小，分别较对照组具统计学差异（P<0.05）。另DM+CTS组正中神经腕-肘的MNCV、SNCV减慢，尺神经运动传导的DML延长、MNCV减慢、小指-腕的SNCV减慢、SNAP波幅减小，且较CTS组及对照组分别有统计学差异（P<0.05）。结论 通过肌电图检查可以早期发现腕管综合征，且糖尿病将加重腕管中正中神经的损伤，电生理检查可及早识别糖尿病周围神经并发症的发生发展。 |
| 英文摘要: |
| Objective To investigate the different data of electrodiagnostic study in first diagnosis of carpal tunnel syndrome (CTS) between diabetes mellitus(DM) patients and ordinary patients. To evaluate the effect of DM on CTS. Methods We recruited 59 outpatients first clinically diagnosed with CTS and 32 healthy people from the Wuxi People’s Hospital during 2022 april to 2023 february. According history, patients were assigned to CTS group、DM+CTS group and control group. All patients had been taken neurophysiological testing including: the distal latency (DML), conduction velocity (MNCV) and amplitude (CMAP) of the movement conduction of the median nerve and ulnar nerve；the conduction velocity (SNCV) and amplitude (SNAP) of the median nerve from thumb to wrist、index fingert to wrist、middle fingert to wrist、carpal to wrist and the ulnar nerve from little finger to wrist. Results of electrodiagnostic(EDX) exam were compared seperately. Results The EDX results of DM+CTS group was significantly worse than CTS group (Z=2.762, P=0.0057). No matter in DM+CTS group or CTS group， conduction of median nerve showed as DML were prolonged、the amplitude of CMAP were decreased、SNCV of each finger to wrist were slowed down、the amplitude of SNAP were decreased，which were respectively with statistical differences compared with the control group (P<0.05). In addition, the MNCV and SNCV of median nerve from carpal to elbow were slow down in DM+CTS group. Mean while, compared to CTS group or control group，the conduction of ulnar nerve were also significantly abnormal. Conclusion Carpal tunnel syndrome can be detected at early stage by EDX testing, while diabetes will aggravate the damage of the median nerve in the carpal tunnel. EDX test can identify the occurrence and development of diabetic peripheral nerve complications early. |
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