[1]庄至坤,郭金花,赵岩,等.股骨头坏死髋关节疼痛和活动度与ARCO分期的相关性分析[J].中医正骨,2020,32(01):21-24.
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股骨头坏死髋关节疼痛和活动度与ARCO分期的相关性分析()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第32卷
期数:
2020年01期
页码:
21-24
栏目:
专家述评
出版日期:
2020-01-20

文章信息/Info

作者:
庄至坤1; 郭金花1; 赵岩2; 薛志鹏2; 陈卫衡3
(1.泉州市正骨医院,福建 泉州 362000; 2.中国中医科学院望京医院,北京 100102; 3.北京中医药大学第三附属医院,北京 100029)
关键词:
股骨头坏死;  髋关节;  疼痛;  关节活动度;  ARCO分期;  数据库
摘要:
目的:分析股骨头坏死髋关节疼痛和活动度与ARCO分期的相关性。方法:从中国股骨头坏死数据库(China osteonecrosis of the femoral head database,CONFHD)中提取2016年7月至2018年12月就诊的ONFH患者的病例资料,提取年龄、ARCO分期、髋关节疼痛视觉模拟量表(visual analogue scale,VAS)评分、髋关节活动度等信息。提取的所有资料均为患者到CONFHD参与医院初次就诊时的资料。分析髋关节疼痛VAS评分和髋关节6个方向活动度与ARCO分期的相关性。结果:1590例ONFH患者的病例资料中同时录入了ARCO分期和髋关节疼痛VAS评分,涉及2429髋。患者的ARCO分期以Ⅱ、Ⅲ期为主,占71%。ONFH患者的髋关节疼痛VAS评分与ARCO分期呈正相关(rs=0.102,P=0.000),Ⅲ、Ⅳ期患者的髋关节疼痛VAS评分较为接近。1378例ONFH患者的病例资料中同时录入了ARCO分期和髋关节屈曲、后伸、内收、外展、内旋、外旋活动度,涉及2068髋。ONFH患者的髋关节屈曲、后伸、内收、外展、内旋、外旋活动度均与ARCO分期呈负相关(rs=-0.233,P=0.000; rs=-0.248,P=0.000; rs=-0.180,P=0.000; rs=-0.210,P=0.000; rs=-0.302,P=0.000; rs=-0.171,P=0.000)。结论:随着ARCO分期的增加,ONFH患者的髋关节疼痛程度随之增强,病变后期患者的髋关节疼痛趋于稳定; 髋关节各个方向的活动度随着ARCO分期的增加而下降。

参考文献/References:

[1] FU W,LIU B,WANG B,et al.Early diagnosis and treatment of steroid-induced osteonecrosis of the femoral head[J].Int Orthop,2019,43(5):1083-1087.
[2] GARDENIERS J W M.Report of the committee of staging and nomenclature[EB/OL].(1993-10-14)[2019-08-01].http://arco-intl.org/Newsletters/Gardeniers-1993-5-2/Gardeniers-1993.htm.
[3] MONT M A,HUNGERFORD D S.Non-traumatic avascular necrosis of the femoral head[J].J Bone Joint Surg Am,1995,77(3):459-474.
[4] 廖小平.成年人与未成年人:多学科的界定[J].江西社会科学,2008(6):202-205.
[5] NILSDOTTER A,BREMANDER A.Measures of hip function and symptoms:Harris hip score(HHS),hip disability and osteoarthritis outcome score(HOOS),Oxford hip score(OHS),Lequesne index of severity for osteoarthritis of the hip(LISOH),and American Academy of Orthopedic Surgeons(AAOS)hip and knee questionnaire[J].Arthritis Care Res(Hoboken),2011,63(Suppl 11):S200-S207.
[6] 孙伟,李子荣.股骨头坏死的分期与分型[J].中国骨与关节杂志,2017,6(6):465-468.
[7] ANDO W,YAMAMOTO K,KOYAMA T,et al.Radiologic and clinical features of misdiagnosed idiopathic osteonecrosis of the femoral head[J].Orthopedics.2017,40(1):e117-e123.
[8] MIN H,XU F,GU R,et al.Potential diagnostic role of diffusion tensor imaging in early-stage osteonecrosis of the femoral head[J].Exp Ther Med,2016,12(5):3347-3352.
[9] 李祥瑞,刘海.CT与MRI在股骨头坏死患者早期诊断及临床分期中的应用价值[J].临床医学研究与实践,2018,3(28):142-143.
[10] CHOI H R,STEINBERG M E,Y CHENG E.Osteonecrosis of the femoral head:diagnosis and classification systems[J].Curr Rev Musculoskelet Med,2015,8(3):210-220.
[11] ZHAO D,XIE H,XU Y,et al.Management of osteonecrosis of the femoral head with pedicled iliac bone flap transfer:a multicenter study of 2190 patients[J].Microsurgery,2017,37(8):896-901.
[12] LI J,WANG J,ZHAO J,et al.BOLD-MRI early detect femoral head osteonecrosis following steroid-treated patients[J].Medicine(Baltimore),2017,96(44):e8401.
[13] KOMPEL A,MURAKAMI A,GUERMAZI A.Magnetic resonance imaging of nontraumatic musculoskeletal emergencies[J].Magn Reson Imaging Clin N Am,2016,24(2):369-389.
[14] CHEE C G,CHO J,KANG Y,et al.Diagnostic accuracy of digital radiography for the diagnosis of osteonecrosis of the femoral head,revisited[J].Acta Radiol,2019,60(8):969-976.
[15] 陈雷雷,张颖.何伟教授采用中医药疗法治疗股骨头坏死的经验[J].中医正骨,2015,27(10):74-77.
[16] NAKAMURA J,KONNO K,ORITA S,et al.Distribution of hip pain in patients with idiopathic osteonecrosis of the femoral head[J].Mod Rheumatol,2017,27(3):503-507.
[17] OSAWA Y,SEKI T,TAKEGAMI Y,et al.Do femoral head collapse and the contralateral condition affect patient-reported quality of life and referral pain in patients with osteonecrosis of the femoral head[J].Int Orthop,2018, 42(7):1463-1468.
[18] FICAT R P.Treatment of avascular necrosis of the femoral head[J].Hip,1983:279-295.
[19] HUANG G S,CHAN W P,CHANG Y C,et al.MR imaging of bone marrow edema and joint effusion in patients with osteonecrosis of the femoral head:relationship to pain[J].AJR Am J Roentgenol,2003,181(2):545-549.
[20] ZOU D,ZHANG K,YANG Y,et al.Th17 and IL-17 exhibit higher levels in osteonecrosis of the femoral head and have a positive correlation with severity of pain[J].Endokrynol Pol,2018,69(3):283-290.
[21] 刘丙立,赵刚,王雪,等.早中期股骨头坏死疼痛与坏死面积及关节积液分级相关性分析[J].实用骨科杂志,2015,21(11):1001-1004.
[22] YAMATO K,KATAOKA T,NISHIYAMA Y,et al.Antinociceptive effects of radon inhalation on formalin-induced inflammatory pain in mice[J].Inflammation,2013,36(2):355-363.
[23] JI R R,XU Z Z,GAO Y J.Emerging targets in neuroinflammation-driven chronic pain[J].Nat Rev Drug Discov,2014,13(7):533-548.
[24] 邱柱雄.非创伤性股骨头坏死不同坏死分期和髋关节功能等级下髋关节积液发生情况[J].中国医学创新,2018,15(21):121-124.

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备注/Memo

备注/Memo:
(收稿日期:2019-08-23 本文编辑:李晓乐)基金项目:国家中医药管理局国家中医临床研究基地业务建设科研专项课题(JDZX2015272); 北京市自然科学基金项目(7182186)通讯作者:陈卫衡 E-mail:drchenweiheng@163.com
更新日期/Last Update: 2020-01-15