膝骨关节炎患者基于MRI下渗出性滑膜炎体积与WOMAC亚域评分的相关性  

Correlation between Volume of Exudative Synovitis under MRI and WOMAC Subdomain Score in Patients with Knee Osteoarthritis

作　　者：王轶稀[1] 丁全茂[1] 程炳瑞 WANG Yixi;DING Quanmao;CHENG Bingrui(Department of Massage,Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院推拿科,北京100053

出　　处：《医学综述》2021年第24期4970-4974,共5页Medical Recapitulate

基　　金：北京市科技重大专项(D171100003217004)。

摘　　要：目的分析膝骨关节炎(KOA)患者基于磁共振成像(MRI)下渗出性滑膜炎体积与西安大略和麦克马斯特大学骨关节炎指数(WOMAC)亚域评分的相关性。方法选取2018年12月至2020年12月中国中医科学院广安门医院、北京中医药大学东方医院、首都医科大学宣武医院、北京市中医院推拿科或骨科门诊收治的67例伴渗出性滑膜炎表型中老年KOA患者作为研究对象,获取治疗前后的MRI渗出性滑膜炎体积与WOMAC亚域评分,使用广义线性回归模型对两类观察指标的横向基础值及纵向变化值进行相关分析。结果无论是否调整性别、年龄、体质指数、入组侧别和干预方式等因素,基线期渗出性滑膜炎体积与基线期各WOMAC亚域评分均无明显相关性(P>0.05),随访期渗出性滑膜炎体积与随访期各WOMAC亚域评分均无明显相关性(P>0.05)。在调整了性别、年龄、体质指数、入组侧别和干预方式等因素的影响后,基线期渗出性滑膜炎体积与治疗前后功能亚域评分的变化值存在相关性(P<0.01),渗出性滑膜炎体积变化值与WOMAC各亚域评分的变化值均存在相关性(P<0.05)。结论渗出性滑膜炎体积与KOA患者临床症状无直接关联,但可在一定程度上预测患者接受外治法治疗后的活动功能改善的收益。渗出性滑膜炎体积变化值与WOMAC亚域评分变化值存在相关性,能为KOA患者短期治疗收益提供客观参考。Objective To analyze the correlation between the volume of exudative synovitis under magnetic resonance imaging(MRI)and the Western Ontario and McMaster Universities(WOMAC)osteoarthritis index subdomain score in patients with knee osteoarthritis(KOA).Methods A total of 67 middle-aged and elderly KOA patients with exudative synovitis who were admitted to the Department of Massage or Orthopedic Outpatient Department of Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Dongfang Hospital of Beijing University of Chinese Medicine,Xuanwu Hospital of Capital Medical University and Beijing Hospital of Traditional Chinese Medicine from Dec.2018 to Dec.2020 were included.The volume of exudative synovitis under MRI and WOMAC subdomain score before and after treatment were obtained.The correlation analysis of the horizontal base value and the longitudinal change value of the two observation indexes was carried out by using the generalized linear regression model.Results Regardless of whether the factors such as gender,age,body mass index,inclusion side and intervention method were adjusted,there was no significant correlation between the volume of exudative synovitis at baseline and the WOMAC subdomain scores during baseline period(P>0.05),and no significant correlation between the volume of exudative synovitis at follow-up and the WOMAC subdomain scores at follow-up(P>0.05).After adjusting the effects of gender,age,body mass index,inclusion side and intervention mode,there was a correlation between the volume of exudative synovitis and the changes of functional subdomain scores before and after treatment during the baseline period(P<0.01),and there was a correlation between the changes of volume of exudative synovitis and the changes of WOMAC subdomain scores(P<0.05).Conclusion The volume of exudative synovitis is not directly related to the clinical symptoms of patients with KOA,but it can predict to a certain extent the benefit of activity function improvement after external treatment.There is a correlation

关 键 词：膝骨关节炎 渗出性滑膜炎 西安大略和麦克马斯特大学骨关节炎指数亚域评分 症状 

分 类 号：R684.3[医药卫生—骨科学]