膝骨关节炎X线分级与疼痛程度的相关性分析  

Correlation Analysis between X-ray Grading and Pain Level of Knee Osteoarthritis

作　　者：王强[1,2] 苟海昕[3] 曹月龙[1] 张国梁[1] 元唯安[1] 陈博[1] 庞坚[1] 孙波 石印玉[1] 

机构地区：[1]上海中医药大学附属曙光医院石氏伤科医学中心,上海201203 [2]上海市黄浦区香山中医医院 [3]复旦大学附属华东医院

出　　处：《中国中医骨伤科杂志》2015年第6期18-21,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：国家自然科学基金项目(81102603;81173277);"海派中医流派传承研究基地"项目(ZYSNXD-C C-HPGC-JD-001);上海领军人才项目(041);上海市中医药事业发展三年行动计划项目(ZYSNX D-CC-ZDYJ047);上海市科学技术委员会科研计划项目(13401902502);上海市卫生局科研项目(20124082)

摘　　要：目的:探讨膝骨关节炎患者X线影像学Kellgren-Lawrence评价与不同状态下膝关节疼痛程度的相关性。方法:收录膝骨关节炎患者310例,参考Kellgren-Lawrence分级法关于膝骨关节炎影像学分级量化标准进行分级,评价患者膝关节X线影像严重程度;采用视觉模拟评分法(Visual Analogue Score,VAS)进行评分,评定患者膝关节的疼痛程度。对患者膝关节(如为双膝,选择较重侧)髌股关节,内侧胫股、外侧胫股,全膝关节(取三者最高值)Kellgren-Lawrence积分数值与不同状态下膝关节疼痛(静息疼痛、平地行走疼痛、上或下楼梯疼痛)VAS评分数值的相关性进行分析。结果:膝骨关节炎X线影像学Kellgren-Lawrence评价与不同状态下膝关节疼痛VAS评分的相关分析结果显示,静息和上下楼梯状态下膝关节疼痛VAS评分与Kellgren-Lawrence积分相关性比较差异有统计学意义,呈正相关(P<0.05)。平地行走时膝关节疼痛VAS评分与髌股关节、外侧胫股、全膝关节Kellgren-Lawrence积分相关性比较差异有统计学意义,呈正相关(P<0.05);与内侧胫股Kellgren-Lawrence、全膝关节在平地行走时积分相关性比较差异无统计学意义(P=0.272;P=0.061)。结论:在上下楼梯和平地行走状态下膝骨关节炎患者髌股关节X线分级与疼痛程度相关,其它部位X线分级与疼痛程度相关性较弱或无相关性;静息状态下膝骨关节炎患者关节X线分级与疼痛程度相关性较弱。Objective：To investigate the correlation between Kellgren-Lawrence（KL）X-ray radiographic evaluation and different states of knee pain level in patients with knee osteoarthritis（KOA）.Methods：310cases of KOA were graded according to KL grading method.The knee joint X-ray images severity was evaluated.The Visual Analogue Scale（VAS）was used to score and assess the knee pain of patients.The correlation between KL value of patellofemoral joint,the medial tibiofemoral,lateral tibiofemoral and total knee（the highest among the three）and the VAS score of knee pain under different states（resting pain,flat walking pain,pain up or down stairs）was analyzed.Results：The results of correlation analysisshowed that there was positive correlation between the VAS score and KL value of patellofemoral joint in condition of resting and up/down stairs（P〈0.05）.And there was also positive correlation between the VAS score and KL value of patellofemoral joint and lateral tibiofemoral joint in condition of walking on flat ground（P〈0.05）;there was no significant correlation when compared with KL value of medial tibiofemoral joint and total knee（P=0.272;P=0.061）.Conclusion：The X-ray grading of patellofemoral joint was associated with knee pain in condition of walking on flat ground and up/down stairs in patients with KOA.The X-ray grading of other parts get a weak correlation or not associated with the level of knee pain.The X-ray grading under the resting state is weakly related with the level of pain in patients with KOA.

关 键 词：骨关节炎 膝关节 疼痛 相关性分析 

分 类 号：R684.3[医药卫生—骨科学]