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目的探讨神经传导参数对慢性正己烷中毒的诊断价值。方法收集79例慢性正己烷中毒患者和38名正常人员的神经传导参数[潜伏期(DL)、波幅(AMP)、传导速度(CV)],按照正常、轻、中、重度中毒分组并对3项参数进行分析,利用受试者工作特征曲线(ROC)曲线评价3项参数在慢性正己烷中毒诊断中的价值并找出其临床诊断界值(Cut off值)。结果①3项参数在各组之间比较,差异有统计学意义(P<0.05),与同组的不同神经比较,差异无统计学意义(P>0.05)。②本研究选择腓神经运动参数作进一步分析,CV在任何组间比较,差异均有统计学意义(P<0.05);DL中度中毒组与重度中毒组比较,差异无统计学意义(P>0.05),其余组间比较,差异均有统计学意义(P<0.05);AMP仅在轻度中毒组与正常组之间比较,差异有统计学意义(P<0.05),其余任何2组差异均无统计学意义(P>0.05)。③ROC分析显示,除了中度中毒组与重度中毒组中DL、AMP 2个参数的曲线下面积(AUC)<0.7以外(P>0.05),其他各组中3个参数的AUC均>0.7(P<0.05);CV的AUC值在各组中最大或较大。结论 3项参数在慢性正己烷中毒的诊断和分级中具有很好的参考意义,其中运动神经CV具有较高的特异性和敏感性。
Objective To investigate the diagnostic value of nerve conduction parameters in chronic n-hexane poisoning. Methods The nerve conduction parameters (DL, AMP, CV) of 79 chronic n-hexane poisoning patients and 38 healthy volunteers were collected and divided into three groups according to normal, mild, moderate and severe poisoning groups. Parameters were analyzed and the value of three parameters in the diagnosis of chronic n-hexane poisoning was evaluated by using the receiver operating characteristic curve (ROC) curve and the clinical cutoff value was found out. Results ① The three parameters were significantly different between groups (P <0.05). There was no significant difference between the three groups (P> 0.05). (2) In this study, the parameters of peroneal nerve were selected for further analysis. CV was statistically significant in any group (P <0.05). There was no significant difference between DL moderate poisoning group and severe poisoning group (P> 0.05). The differences between the other groups were statistically significant (P <0.05). The difference was statistically significant only in mild poisoning group and normal group (P <0.05) No statistical significance (P> 0.05). (3) The ROC analysis showed that the AUC of the two parameters of DL and AMP in the moderate and severe poisoning groups were lower than 0.7 (P> 0.05), and the AUCs of the other three groups were all higher than 0.7 (P <0.05); the AUC value of CV was the largest or the largest in each group. Conclusion The three parameters have good reference value in the diagnosis and classification of chronic n-hexane poisoning, in which the motor nerve CV has high specificity and sensitivity.