摘要
目的研究神经根型颈椎病（CSR）患者出现根性损害及合并腕管综合征（CTS）的情况及其电生理改变特点，探讨CSR与CTS之间可能的联系。方法对2013年9月至2014年2月在北京协和医院诊断为CSR的124例患者行肌电图检查，根据肌电图检查结果分为根性损害组与根性损害合并CTS组，统计出现根性损害及CTS的比例，比较两组间运动末端潜伏期（DML）、运动神经传导速度（MCV）、感觉神经传导速度（SCV）、感觉电位波幅（SNAP）、复合肌肉动作电位波幅（CMAP）及自发电位改变；比较C6、C7、C8对应节段合并CTS的发生率。结果124例患者中肌电图正常29例，根性损害81例（65．3％），根性损害合并CTS14例（11．3％），其中男性4例，女性10例，双侧CTS10例；81例中76例患者CMAP、DML、MCV、SCV和SNAP均正常，3例CMAP较正常降低5％～12％，2例DML较正常延长3％和9％。合并CTS患者中单纯SCV异常9例，SCV较正常减慢26％-47％，SNAP波幅正常或降低58％～86％，5例除感觉神经传导异常外尚有运动神经传导异常，CMAP较正常下降31％-78％，3例DML较正常延长27％-39％，2例MCV较正常下降32％和40％，拇短展肌有自发电位活动5例；分析在对应C6（27．4％，9／33）、C7（26．9％，7／26）和C8（5／7）节段合并CTS的发生率，经卡方检验差异有统计学意义（χ^2=5．96，P〈0．01）。结论CSR出现根性损害和CTS比例均较高，且根性损害合并CTS时CMAP降低，DML明显延长，提示可能存在双卡压机制。
Objective To explore the relationship between cervical spondylotic radiculopathy （CSR） and carpal tunnel syndrome （CTS） by investigating their electrophysiologieal characteristics and the incidence of CSR root injury and root injury complicating with CTS. Methods One hundred and twenty-four cases of CSR diagnosed in Peking Union Medical College Hospital from September 2013 to February 2014 by eleetromyography （EMG） were recruited. According to the resuhs of EMG, patients were divided into root injury and root injury complicating with CTS groups. The distal motor latency （DML）, motor nerve conduction velocity （MCV）, sensory nerve conduction velocity （SCV）, sensory nerve action potential （SNAP）, compound muscle action potential （CMAP） and spontaneous potential （SP） were compared between the two groups. Results There were 81 （65.3%） cases with root injury, 11 cases with double sides injury and 29 cases with normal EMG among these 124 patients. The CMAP, DML, MCV, SCV and SNAP were normal in 76 cases, CMAP lowered 5% - 12% in 3 cases, DML extended 3% and 9% in 2 cases. There were 14 eases （11.3%） with concomitant CTS （female 10 cases and male 4 cases,double sides CTS 10 cases）. Among the 14 eases with concomitant CTS, there were 9 cases with simply sensory nerve conduction abnormality, SCV slowing down 26% - 47%, SNAP reducing 58% - 86% or normal, while other 5 cases with motor conduction abnormality as well as sensory nerve conduction abnormality, CMAP reducing 21% -78%, DML extending 27% -39% in 3 cases, MCV slowing down 32% and 40% in 2 cases. Five cases had spontaneous electricity position movement in the abductor pollieis brevis. The incidence of root injury complicating with CTS in C6 （ 27.4%, 9/33 ）, C7 （ 26. 9%, 7/26 ） and C8 （ 5/7 ） showed statistically significant difference （ χ2 = 5.96, P 〈 0. 01 ）. Conclusions There is a high incidence of root injury and CTS in CSR patients,indicating a possible double crush between CSR and CTS.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2015年第2期120-122,共3页
Chinese Journal of Neurology
关键词
神经根病
脊柱骨赘病
颈椎
腕管综合征
肌电描记术
神经卡压综合征
Radiculopathy
Spinal osteophytosis
Cervical vertebrae
Carpal tunnelsyndrome
Electromyography
Nerve compression syndromes
