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[1]洪海平,衛(wèi)曉恩,陳勇,等.膝骨關節(jié)炎患者股四頭肌肌張力與膝關節(jié)功能 的關系研究[J].中醫(yī)正骨,2014,26(10):32-34.
　Hong Haiping*,Wei Xiaoen,Chen Yong,et al.Study on the relationship between quadriceps femoris muscle tonus and knee function in patients with knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2014,26(10):32-34.
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膝骨關節(jié)炎患者股四頭肌肌張力與膝關節(jié)功能 的關系研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第26卷
期數(shù):
2014年10期
頁碼:
32-34
欄目:
臨床研究
出版日期:
2014-10-30

文章信息/Info

Title:
Study on the relationship between quadriceps femoris muscle tonus and knee function in patients with knee osteoarthritis
作者:
洪海平1; 衛(wèi)曉恩2; 陳勇1; 張明云1; 徐玉云1; 朱首豪 1; 詹紅生2
1.上海中醫(yī)藥大學附屬曙光醫(yī)院松江分院,上海 201699;
2.上海中醫(yī)藥大學附屬曙光醫(yī)院,上海 200021
Author(s):
Hong Haiping*; Wei Xiaoen; Chen Yong; Zhang Mingyun; Xu Yuyun; Zhu Shouhao; Zhan Hongsheng.*
Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Songjiang branch,Shanghai 201699,China
關鍵詞:
骨關節(jié)炎 膝關節(jié) 股四頭肌 肌張力 相關分析 回歸分析
Keywords:
Osteoarthritis;  Knee joint;  Quadriceps femoris;  Muscle tonus;  Correlation analysis;  Regression analysis
摘要:
目的:探討膝骨關節(jié)炎患者股四頭肌肌張力與膝關節(jié)功能的關系。方法:選擇80例單側膝骨關節(jié)炎患者,采用Myotonometer 肌肉狀態(tài)測試系統(tǒng)測定并對比患者雙側股四頭肌的肌張力,同時采用美國特種外科醫(yī)院膝關節(jié)評分標準評定患側膝關節(jié)功能,采 用相關分析和回歸分析的方法研究股四頭肌肌張力與膝關節(jié)功能的關系。結果:①股四頭肌肌張力。靜息狀態(tài)下健側股內側肌壓 力-位移曲線下面積、股直肌壓力-位移曲線下面積、股外側肌壓力-位移曲線下面積及股四頭肌壓力-位移曲線下面積均值均低 于患側,差異均有統(tǒng)計學意義[(20.97±3.36)kg·mm,(22.78±2.85)kg·mm,t=-4.935,P=0.000;(18.00±3.69)kg ·mm,(18.98±3.91)kg·mm,t=-3.309,P=0.002;(17.78±3.55)kg·mm,(19.19±3.31)kg·mm,t=- 4.437,P=0.000;(18.89±3.02)kg·mm,(20.32±2.94)kg·mm,t=-7.704,P=0.000]。②股四頭肌肌張力與膝關節(jié)功能的 相關分析。本組患者患側美國特種外科醫(yī)院膝關節(jié)功能評分為(74.72±8.87)分。直線相關分析結果顯示,患側膝關節(jié)功能 評分與靜息狀態(tài)下股內側肌壓力-位移曲線下面積、股直肌壓力-位移曲線下面積、股外側肌壓力-位移曲線下面積及股四頭肌壓 力-位移曲線下面積均值均呈負相關(r=-0.686,P=0.000; r=-0.570,P=0.000; r=-0.656,P=0.000; r=-0.719,P=0.000)。③股四 頭肌肌張力與膝關節(jié)功能的回歸分析。本組患者患側美國特種外科醫(yī)院膝關節(jié)功能評分與股四頭肌靜息狀態(tài)下壓力-位移曲線下 面積均值的散點圖提示二者存在直線相關趨勢。以患側膝關節(jié)功能評分為自變量(X),以患側股四頭肌靜息狀態(tài)下壓力-位移曲線 下面積均值為因變量(Y),建立直線回歸方程,Y=38.57-0.244X(F=62.126,P=0.000)。結論:膝骨關節(jié)炎患者患側股四頭肌肌張力 與膝關節(jié)功能呈負線性關系。由此推測,股四頭肌肌張力降低可能既是膝骨關節(jié)炎的病變結果又是其病因,而通過改善患側股四 頭肌肌張力或許能從力學機制上阻斷或減緩膝骨關節(jié)炎發(fā)展的惡性循環(huán)。
Abstract:
Objective:To explore the relationship between quadriceps femoris muscle tonus and knee function in patients with knee osteoarthritis(KOA).Methods:Eighty patients with unilateral KOA were selected for measuring and comparing the bilateral quadriceps femoris muscle tonus in relaxed state by using Myotonometer,and the joint function of the affected knee was evaluated according to the Hospital for Special Surgery(HSS)knee performance score,and correlation analysis and regression analysis were applied to study the relationship between quadriceps femoris muscle tonus and knee function.Results:The area under curve(AUC)of pressure displacement curve of vastus medialis,rectus femoris,vastus lateralis and quadriceps femoris were lower in the uninjured legs compared with the affected legs(20.97+/-3.36 vs 22.78+/-2.85 kg/mm,t=-4.935,P=0.000; 18.00+/- 3.69 vs 18.98+/-3.91 kg/mm,t=-3.309,P=0.002; 17.78+/-3.55 vs 19.19+/-3.31 kg/mm,t=-4.437,P=0.000; 18.89+/-3.02 vs 20.32+/-2.94 kg/mm,t=-7.704,P=0.000).The HSS knee scores of affected side were 74.72+/-8.87 points,and the results of the linear correlation analysis showed the HSS knee scores of affected side were negatively correlated with the AUC of vastus medialis,rectus femoris,vastus lateralis and quadriceps femoris(r=- 0.686,P=0.000; r=-0.570,P=0.000; r=-0.656,P=0.000; r=-0.719,P=0.000).The scatter diagram showed that there was a trend of linear correlation between HSS knee scores and mean values of quadriceps femoris AUC in the affected side in the relaxed state.The HSS knee scores of affected side were chosen as the independent variable(X)and the mean value of quadriceps femoris AUC of affected side in the relaxed state were chosen as dependent variable(Y)to establish the linear regression equationY=38.57-0.244X(F=62.126,P=0.000).Conclusion:There is negative linear correlation between quadriceps femoris muscle tonus and knee function of affected knees in patients with KOA.Therefore we can infer that the decrease of quadriceps femoris muscle tension may be both the pathological results and the cause of KOA,and the vicious circle of KOA development may be blocked or slowed down by the means of improving quadriceps femoris muscle tonus on affected side.

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備注/Memo

備注/Memo:
基金項目:上海市中醫(yī)藥科研基金項目(2012QL004A,2012L027B),上海市松江區(qū)中西醫(yī)結合骨傷特色專科項目(2013ZK01),上海市 松江區(qū)第三周期醫(yī)學領先專業(yè)項目(2012-Ⅲ-36)
通訊作者:衛(wèi)曉恩 E-mail:[email protected]
更新日期/Last Update: 2014-10-30