类风湿关节炎患者腕管综合征的超声及电诊断研究

Rania El-Abeady, Soad Elsawy, Marwa Ali Abd El-Rahim
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摘要

类风湿性关节炎(RA)是一种以关节和关节外结构为特征的自身免疫性疾病。腕管综合征(Carpal tunnel syndrome, CTS)是类风湿性关节炎最常见的关节外表现之一。目的探讨风湿性关节炎(RA)患者CTS的发生率及超声检查(US)与神经传导检查(NCS)的准确性。患者和方法这是一项在Al-Zahraa大学医院进行的病例对照研究。研究对象是50名RA患者和30名对照组。采用病史记录、临床评价、疾病活动度评分28分评估RA疾病活动度、健康评估问卷评估残疾程度、波士顿问卷评估功能状态、双侧中位(MN) NCS和US(用于腕管不同水平正中神经横截面积和平坦比及其他腕管内容物的检查)对患者进行评估。结果经US诊断为CTS的RA患者占27%,经NCS诊断为20%。RA患者与对照组在三个不同水平的横扫横截面积和横扫平比有高度显著性差异(P<0.07和0.001)。在诊断RA患者CTS时,US和NCS结果呈正相关(P<0.001)。结论超声具有早期发现CTS的优势,可对MN及其周围形态进行评估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prevalence of carpal tunnel syndrome in patients with rheumatoid arthritis by ultrasonographic and electrodiagnostic studies
Introduction Rheumatoid arthritis (RA) is an autoimmune disease characterized by articular and extra-articular structures. Carpal tunnel syndrome (CTS) is one of the most frequent extra-articular manifestations of RA. Aim To detect the prevalence of CTS in patients with RA and the accuracy of ultrasonography (US) in comparison with nerve conduction study (NCS). Patients and methods This was a case–control study carried out at Al-Zahraa University Hospital. It was conducted on 50 patients with RA and 30 controls. They were evaluated by history taking, clinical evaluation, assessment of RA disease activity by disease activity score 28, disability by Health Assessment Questionnaire, functional status by the Boston Questionnaire, bilateral median (MN) NCS, and US, which was used for cross-sectional area and flat ratio of the median nerve at different levels of carpal tunnel and examination of other carpal tunnel contents. Results CTS was diagnosed in 27% of the patients with RA by US and 20% by NCS. There was a highly significant difference between the patients with RA and control groups regarding cross-sectional area and flat ratio of the transverse scan of the MN at three different levels (P<0.07 and 0.001). There was a positive relation between the outcome of US and the NCS in the diagnosis of CTS in patients with RA (P<0.001). Conclusion US has the advantage of early detection of CTS and can assess the morphology of MN and its surroundings.
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