腕管综合征正中神经损伤的生物力学机制研究

腕管综合征是常见的上肢周围神经病变。神经损伤的重要原因之一是长期过度压力和重复性的手部运动引起的正中神经的纵向拉伸应变。临床上，尚不清楚腕管综合征病人的正中神经在手部运动中的三维动态生物力学特性及神经细胞的力学损伤机理。本研究结合了基于自由臂超声动态成像与声辐射力脉冲成像的多模态超声技术，有限元力学仿真方法和细胞生物力学实验通过测量三维正中神经的伪动态拉伸应变和剪切模量的时空特性，构建手指屈伸运动中正中神经压缩应力与拉伸应力的损伤模型，将应力载荷加载在神经细胞上，通过分析细胞损伤阈值以及肌动蛋白细胞骨架形态和蛋白表达，探索腕管综合征的发病机制。分析腕管内正中神经的三维生物力学特性有助于更全面地理解腕管综合征的生物力学发病机理，同时在临床上有辅助非创诊断与评估周围神经病变的意义。

Carpal tunnel syndrome is a common peripheral neuropathy in hand. The longitudinal tensile strain of the median nerve resulted from prolonged excessive mechanical pressure and repetitive hand movement is one of the causes of nerve injury. The 3D dynamic mechanical characteristics and mechanical damage mechanism of the median nerve in carpal tunnel syndrome patients still remain unclear. This study is based on multi-modal ultrasound imaging，including freehand dynamic ultrasound imaging and acoustic radiation force impulse imaging, which assesses 3D median nerve dynamic tensile strain and shear modulus, and finite element analysis, which analyzes the compressive and tensile stress insult to the median nerve during hand movement with the damage model, as well as cellular biomechanics approaches, which analyzed the cell damage stress threshold and actin cytoskeletal shape and protein expression. The study aims to explore the mechanical mechanism of carpal tunnel syndrome by using multi-modal ultrasound imaging, and finite element analysis and cellular biomechanics. The 3D mechanical assessment of the median nerve in the carpal tunnel can improve the understanding of the etiology of carpal tunnel syndrome and aid the non-invasive diagnosis and assessment of peripheral neuropathy in clinical use.