摘要
目的探讨马尾神经传导时间(cauda equina conduction time,CECT)与腰椎管狭窄症(lumbar spinal stenosis,LSS)神经源性间歇性跛行(Neurogenic intermittent claudication,NIC)类型的关系。方法选择2016年9月~2019年6月在本院接受手术治疗的102例LSS患者作为研究组,抽取同期在本院健康体检的47例受试者作为对照组,研究组患者根据NIC类型分为马尾型(cauda equina-type,CE型)43例、混合型(mixed-type,MX)37例、根型(radicular-type,R型)22例。分析研究组和对照组CECT差异,观察研究组三个亚型CECT差异、硬脑膜囊面积(dural sac area,DSCA),观察CECT与DSCA的相关性,采用多因素回归分析观察影响CECT的因素。结果研究组患者中CE型、MX型、R型三个亚型CECT均显著高于对照组,且CE型、MX型高于R型,CE型高于MX型,差异均有统计学意义(P<0.05)。CE型、MX型、R型患者DSCA差异存在统计学意义(P<0.05),进一步两两分析显示,CE和MX型低于R型,CE型低于MX型,差异均有统计学意义(P<0.05)。Spearman相关分析显示,CE分型和MX分型患者DSCA和CECT呈负相关(r=-0.447、-0.492,P<0.001),R型患者DSCA与CECT结果不存在相关性(r=0.108,P>0.05)。多元回归分析显示,CE型、MX型NIC是CECT的危险因素(P<0.05),而DSCA是CECT的保护性因素(P<0.05)。结论CECT是评估LSS患者运动神经通路的客观、定量方法,可对LSS患者进行快速、简便的进行无创性检查和评价,以鉴别LSS的功能亚型。
Objective To investigate the relationship between cauda equina conduction time(CECT)and neurogenic intermittent claudication(NIC)types in lumbar spinal stenosis(LSS).Methods From September 2016 to June 2019,102 LSS patients who received surgical treatment in our hospital were selected as the study group,and 47 healthy subjects in our hospital during the same period were selected as the control group.According to the type of NIC,the patients in the study group were divided into cauda equina type(CE type)43 cases,mixed type(MX type)37 cases,root type(R type)22 cases.The difference of CECT between the study group and the control group was analyzed.The differences of CECT,dural sac area(DSCA)and the correlation between CECT and DSCA were observed.Multivariate regression analysis was used to observe the influencing factors of CECT.Results CECT of CE,MX and R subtypes in the study group was significantly higher than that in the control group,and comparison between subgroups of study group showed that CE type and MX type were higher than R type,CE type was higher than MX type,the differences were statistically significant(P<0.05).There were statistically significant differences in DSCA among CE type,MX type and R type patients(P<0.05).Further pairwise analysis showed that CE and MX type were lower than R type,CE type was lower than MX type,the differences were statistically significant(P<0.05).Spearman correlation analysis showed that there was a negative correlation between DSCA and CECT in patients with CE classification and MX classification(r=-0.447,-0.492,P<0.001),but there was no correlation between DSCA and CECT in patients with R type(r=0.108,P>0.05).Multiple regression analysis showed that CE type and MX type NIC were risk factors of CECT(P<0.05),while DSCA was a protective factor(P<0.05).Conclusion CECT is an objective and quantitative method for the evaluation of motor nerve pathway in patients with LSS.It can be used for rapid and simple noninvasive examination and evaluation of LSS patients,so as to identify the functional subtypes of LSS.
作者
张芳权
ZHANG Fang-quan(Xinyang Central Hospital,Xinyang,Henan 464000,China)
出处
《颈腰痛杂志》
2021年第3期298-300,304,共4页
The Journal of Cervicodynia and Lumbodynia
基金
宁夏回族自治区自然科学基金(编号:NZ16212)。
关键词
腰椎管狭窄症
神经源性间歇性跛行
马尾神经传导时间
lumbar spinal stenosis
neurogenic intermittent claudication
cauda equina conduction time
