高频超声在无症状型系统性硬化病患者腕管综合征早期诊断的应用

Application of ultrasonography in diagnosis of carpal tunnel syndrome in patients with asymptomatic systemic sclerosis

关键词:  系统性硬化病  腕管综合征  高频超声

Key words:  systemic sclerosis  carpal tunnel syndrome  high resolution ultrasound

摘要:

目的探讨高频超声在无症状型系统性硬化病（systemic sclerosis,SSc）腕管综合征早期诊断的应用价值。方法研究组选取49例SSc患者,对照组选取30例健康人,应用高频超声分别测量腕管豌豆骨水平处的正中神经截面积（median nerve area,MNA）,正中神经横径（median nerve transversal diameter,MNT）以及正中神经前后径（median nerve antero-posterior diameter,MNAP）,计算正中神经扁平率（median nerve flattening ratio,MNFR）同时记录病程、类型（弥漫型或局限型）及皮肤受累阶段（水肿期,纤维化期,萎缩期）。结果 SSc患者正中神经横截面积,正中神经横径,正中神经扁平率明显高于对照组,差异有统计学意义（P〈0.05）,而正中神经前后径在两组间比较无统计学意义（P〉0.05）。正中神经扁平率与病程呈正相关,Spearman等级相关系数为0.3。结论高频超声在早期诊断无症状型SSc患者腕管综合征有较高的临床价值。

Abstract:

Objective To evaluate the application of high resolution ultrasonography in diagnosis of carpal tunnel syndrome（ CTS） in patients with asymptomatic systemic sclerosis（ SSc）.Methods Forty nine SSc patients and 30 healthy subjects underwent high-resolution ultrasonography examination. The median nerve area（ MNA）,median nerve transversal diameter（ MNT） and median nerve antero-posterior diameter（ MNAP） at carpal tunnel were measured. Median nerve flattening ratio（ MNFR） was calculated. Duration of disease,types of disease（ limited,diffuse） and stages of skin involvement（ edematous,atrophic,fibrotic） were also recorded. Results MNA,MNT and MNFR at carpal tunnel were significantly higher in the SSc patients than those in controls,while no difference in MNAP was found. MNFR was correlated with disease duration with a spearman coefficient of 0. 3.Conclusion Median nerve involvement is frequently present in all stages of asymptomatic SSc,it can be early detected by high-resolution ultrasonography.