A GENDER SPECIFIC WRIST RATIO AND THE LIKELIHOOD OF A MEDIAN NERVE ABNORMALITY AT THE CARPAL TUNNEL
A GENDER SPECIFIC WRIST RATIO AND THE LIKELIHOOD OF A MEDIAN NERVE ABNORMALITY AT THE CARPAL TUNNEL
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不同性别的手腕比例和腕管正中神经异常的可能性
DOI：
10.1097/00002060-199406000-00003
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发表时间：
1994
影响因子：
3
通讯作者：
P. Radecki
中科院分区：
文献类型：
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作者：
P. Radecki
本研究的目的是阐明患者腕关节比率与腕管中位数异常之间的相关性的意义。在665例至少累及一只手或前臂的患者中测定了平均腕比和正中神经松弛度。419名女性的平均腕关节比率（0.690）超过246名男性（0.672），差异显著（平均差异0.018; 95%置信区间，0.012至0.024; P<0.0001）。236名女性的平均手腕比率（0.704），中位数异常超过183名妇女（0.672）无中位潜伏期异常（差异0.032; 95%置信区间，0.026至0.038; P<0.0001）; 166名男性的平均腕关节比率（0.681），中位数异常超过80名男性（0.655），无中位潜伏期异常（差异0.026; 95%置信区间，0.016至0.035; P<0.0001）。回归分析显示，平均腕比率的增加与优势手正中神经运动和感觉潜伏期的减慢呈正相关，最佳潜伏期相关性为女性（r=0.394，P<0.0001）和男性（r=0.329，P<0.0001）的中位数减去尺骨手掌到腕的潜伏期差异。在79%的女性和86.9%的男性中发现了平均腕比为0.7或更大的中位数异常;女性的平均腕比为0.7或更大的比例为73.8%。患者腕关节比率（和相关因素）似乎是一个重要的，但混淆变量相对于以前的流行病学调查的腕管综合征，并可能是一个关键因素，在解释更大的患病率正中神经病变在女性的腕管和双边发生的情况下的趋势。
The objective of this study was to clarify the significance of the association of the patient wrist ratio and a median abnormality at the carpal tunnel. The average wrist ratio and median nerve latencies were determined in 665 patients with symptoms involving at least one hand or forearm. The mean average wrist ratio of the 419 women (0.690) exceeded that of the 246 men (0.672), differing significantly (mean difference 0.018; 95% confidence interval, 0.012 to 0.024; P<0.0001). The mean average wrist ratio of the 236 women (0.704) with a median abnormality exceeded that of the 183 women (0.672) without a median latency abnormality (difference 0.032; 95% confidence interval, 0.026 to 0.038; P<0.0001); the mean average wrist ratio of the 166 men (0.681) with a median abnormality exceeded that of the 80 men (0.655) without a median latency abnormality (difference 0.026; 95% confidence interval, 0.016 to 0.035; P<0.0001). Regression analyses revealed an increasing average wrist ratio to correlate positively with a slowing of the dominant hand median nerve motor and sensory latencies, with the best latency correlation being the median minus the ulnar palm-to-wrist latency difference in the women (r=0.394, P<0.0001) and in the men (r=0.329, P<0.0001). A median abnormality was found in 79% of the women and in 86.9% of the men with an average wrist ratio of 0.7 or greater; women had 73.8% of the average wrist ratios of 0.7 or greater. The patient wrist ratio (and related factors) seems a vital yet confounding variable relative to much of the previous epidemiologic investigation of the carpal tunnel syndrome, and may be a key element in explanation of the greater prevalence of a median neuropathy at the carpal tunnel in women and the tendency of a bilateral occurrence of the condition.