[1]洪海平,卫晓恩,陈勇,等.膝骨关节炎患者股四头肌肌张力与膝关节功能 的关系研究[J].中医正骨,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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膝骨关节炎患者股四头肌肌张力与膝关节功能 的关系研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第26卷
期数:
2014年10期
页码:
32-34
栏目:
临床研究
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; 卫晓恩2; 陈勇1; 张明云1; 徐玉云1; 朱首豪 1; 詹红生2
1.上海中医药大学附属曙光医院松江分院,上海 201699;
2.上海中医药大学附属曙光医院,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
关键词:
骨关节炎 膝关节 股四头肌 肌张力 相关分析 回归分析
Keywords:
Osteoarthritis;  Knee joint;  Quadriceps femoris;  Muscle tonus;  Correlation analysis;  Regression analysis
摘要:
目的:探讨膝骨关节炎患者股四头肌肌张力与膝关节功能的关系。方法:选择80例单侧膝骨关节炎患者,采用Myotonometer 肌肉状态测试系统测定并对比患者双侧股四头肌的肌张力,同时采用美国特种外科医院膝关节评分标准评定患侧膝关节功能,采 用相关分析和回归分析的方法研究股四头肌肌张力与膝关节功能的关系。结果:①股四头肌肌张力。静息状态下健侧股内侧肌压 力-位移曲线下面积、股直肌压力-位移曲线下面积、股外侧肌压力-位移曲线下面积及股四头肌压力-位移曲线下面积均值均低 于患侧,差异均有统计学意义[(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股四头肌肌张力与膝关节功能的 相关分析。本组患者患侧美国特种外科医院膝关节功能评分为(74.72±8.87)分。直线相关分析结果显示,患侧膝关节功能 评分与静息状态下股内侧肌压力-位移曲线下面积、股直肌压力-位移曲线下面积、股外侧肌压力-位移曲线下面积及股四头肌压 力-位移曲线下面积均值均呈负相关(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 头肌肌张力与膝关节功能的回归分析。本组患者患侧美国特种外科医院膝关节功能评分与股四头肌静息状态下压力-位移曲线下 面积均值的散点图提示二者存在直线相关趋势。以患侧膝关节功能评分为自变量(X),以患侧股四头肌静息状态下压力-位移曲线 下面积均值为因变量(Y),建立直线回归方程,Y=38.57-0.244X(F=62.126,P=0.000)。结论:膝骨关节炎患者患侧股四头肌肌张力 与膝关节功能呈负线性关系。由此推测,股四头肌肌张力降低可能既是膝骨关节炎的病变结果又是其病因,而通过改善患侧股四 头肌肌张力或许能从力学机制上阻断或减缓膝骨关节炎发展的恶性循环。
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.

参考文献/References:

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备注/Memo

备注/Memo:
基金项目:上海市中医药科研基金项目(2012QL004A,2012L027B),上海市松江区中西医结合骨伤特色专科项目(2013ZK01),上海市 松江区第三周期医学领先专业项目(2012-Ⅲ-36)
通讯作者:卫晓恩 E-mail:xinxinyu8101@163.com
更新日期/Last Update: 2014-10-30