强度-时间曲线检测在颈源性肩周炎诊断中的应用  

Application of strength-duration curve detection in diagnosis of cervicogenic periarthritis of shoulder

作　　者：李世刚[1] 罗子芮[1] 汤远兴[1] 梁潇[1] 

机构地区：[1]南方医科大学附属南海医院,佛山528200

出　　处：《中国康复医学杂志》2012年第9期829-832,共4页Chinese Journal of Rehabilitation Medicine

基　　金：佛山市医学类科技攻关项目(201008126)

摘　　要：目的:探讨强度-时间曲线测定用于颈源性肩周炎的诊断价值。方法:2010年8月—2011年12月共有169例肩周炎患者进入本研究。其中颈源性肩周炎84例,单纯性肩周炎患者85例。使用CX-3电诊断仪对患者进行强度-时间曲线测定,分别检测冈上肌、冈下肌、小圆肌和三角肌四块肌肉。判断标准分为正常神经支配、部分与完全失神经支配,计算各肌肉及总的阳性率,比较四块肌肉阳性率的差异,并记录四块肌肉的基强度、时值。结果:颈源性肩周炎的强度-时间曲线测定阳性率为92.86%;冈上肌、冈下肌、小圆肌和三角肌的阳性率分别为75.00%、91.67%、90.48%、59.52%,其中冈下肌与小圆肌的阳性率明显高于三角肌,也高于冈上肌的阳性率;正常与失神经支配肌肉的基强度无明显差异,而后者的时值明显高于前者。结论:强度-时间曲线测定用于颈源性肩周炎的诊断具有鉴别诊断意义;临床上检测建议选择冈下肌与小圆肌两块肌肉,基强度仅作为参考,而时值具有诊断意义。Objective： To explore the effect of strength-duration curve detection in diagnosis of cervicogenic periarthritis of shoulder. Method： One hundred and sixty-nine patients were recruited into this study from Aug 2010 to Dee 2011, of which 84 patients with cervicogenic periarthritis of shoulder and 85 with pure periarthritis of shoulder. Supraspina- tus, infraspinatus, teres minor and triangular muscle were detected with strength-duration curve. The total positive rate and four muscle＇s positive rates were calculated, rheobase and ehronaxia value were recorded. Result：The total positive rate of strength-duration curve in patients with cervicogenic periarthritis of shoulder was 92.86% ,while which of supraspinatus, infraspinatus, teres minor and triangular muscle were 75.00% ,91.67%, 90.48% and 59.52%respectively. The rheobase between innervated and denervated muscle, had no differences, however, chronaxia of denervated muscles was higher than that of innervated muscles. Conclusion： Strength-duration curve can be used in diagnosis of cervieogenic periarthritis of shoulder from pure periarthritis of shoulder. Infraspinatus, teres minor muscle are recommended in clinical detection. Chronaxia is meaningful in diagnosis of cervicogenic periarthritis of shoulder, but rheobase is much less meaningful.

关 键 词：强度-时间曲线 颈源性肩周炎 基强度 时值 

分 类 号：R684[医药卫生—骨科学] R493[医药卫生—外科学]