Objective To provide the evidences for the choice of normal reference value of nerve conduction velocity (NCV) in clinical forensic appraisal. Methods One hundred and fourteen cases with normal peripheral nerve and 155 cases with injured peripheral nerve were collected. The NCV of homonymous nerves in two limbs were detected. In the normal cases, the NCV of the left limbs were used as the normal reference values. The NCV of the right limbs were compared with that of left limbs, the commendatory normal reference values from Beijing Xiehe Hospital and Shanghai Huashan Hospital. In the injured cases, the results of NCV in injuried limbs were compared with the results of healthy limbs and the reference values from Beijing Xiehe Hospital and Shanghai Huashan Hospital. Results In the normal group, there was no statistical difference between the left and right limbs in NCV results of homonymous nerve (P>0.05). The false positive rates (FPR) were 0, 11.4% and 5.2% for three choices normal reference respectively. The false negative rates (FNR) were 0, 9.7% and 12.3% for three choices normal reference in injuried group. The false negative cases were all slight nerve injury. Conclusion The reference value of self-control method could decrease the FPR of normal cases and FNR of injured cases. In clinical forensic appraisal of peripheral nerve, the nerve condition study results from healthy homonymous nerve should be regarded as the reference value at first, supplemented by reference values from clinical labs.%目的 为法医临床学鉴定实践中周围神经传导检测正常参考值的选择提供依据.方法 选取周围神经正常者114例和周围神经损伤者155例,对双侧肢体的同名神经进行神经传导检测.在正常组中,以左侧肢体的检测结果作为正常参考值,将右侧肢体的检测结果分别与左侧、北京协和医院和上海华山医院推荐的正常参考值进行比较并进行统计.在损伤组中,将伤侧肢体的检测结果分别与健侧、北京协和医院和上海华山医院推荐的正常参考值进行比较并进行统计.结果 正常组中,左、右侧肢体同名神经的神经传导检测结果之间差异无统计学意义(P＞0.05),3种正常参考值选择方法的假阳性率依次为0、11.4％、5.3％,其中假阳性者均被误认为神经轻度损伤.损伤组中,3种正常参考值选择方法的假阴性率依次为0、9.7％、12.3％,其中假阴性者均为神经轻度损伤. 结论 以自身对侧肢体神经传导检测结果作为正常参考值时,可以降低正常者的假阳性率和损伤者的假阴性率.法医学鉴定中周围神经损伤的神经传导检测应当首先选择健侧同名神经的检测结果作为正常参考值,并辅以临床实验室推荐的正常参考值.
展开▼
