基于剪切波弹性成像的业余马拉松运动员比赛前后髌腱弹性变化定量分析  

Quantitative analysis of patellar tendon elasticity of amateur marathon runners after a competition based on shear wave elastography

作　　者：李波 张贺彬[1] 余燕成 胡佩佩 杨寸芯 张红梅 高枫[1] Li Bo;Zhang Hebin;Yu Yancheng;Hu Peipei;Yang Cunxin;Zhang Hongmei;Gao Feng(Department of Ultrasonography,Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,China)

机构地区：[1]杭州师范大学附属医院超声医学科,杭州310015

出　　处：《中华医学杂志》2022年第9期654-658,共5页National Medical Journal of China

摘　　要：目的应用剪切波弹性成像(SWE)定量分析业余马拉松运动员半程马拉松运动前后的髌腱弹性变化。方法招募47名业余马拉松运动员为马拉松组,其中男31名,女16名,年龄20~44(31.8±5.7)岁,根据运动习惯分为优势侧(47侧)及非优势侧髌腱(47侧),于半程马拉松赛前、赛后2 h及赛后1周对双侧髌腱进行灰阶超声及SWE检查,获得双侧髌腱的弹性值。另招募30名健康志愿者为对照组,其中男18名,女12名,年龄22~39(29.4±4.1)岁,获取双侧髌腱静息状态下弹性值。分析两组间弹性值变化,多因素logistic回归分析赛后髌腱弹性值变化与跑龄、周跑量间的关系。结果所有受试者测试期间均未出现明显膝关节疼痛及运动性损伤。赛前马拉松组优势侧髌腱弹性值高于非优势侧[(55.1±15.7)kPa比(43.8±15.9)kPa,P<0.05];赛前马拉松组优势侧、非优势侧弹性值均高于对照组[(55.1±15.7)kPa比(18.5±3.7)kPa,(43.8±15.9)kPa比(17.4±3.2)kPa](均P<0.05)。与赛前相比,赛后2 h马拉松组优势侧、非优势侧弹性值均增高[(80.2±23.2)kPa比(55.1±15.7)kPa,(76.5±26.6)kPa比(43.8±15.9)kPa](均P<0.05);赛后1周弹性值基本恢复赛前水平(P>0.05)。Logistic回归分析显示跑龄、周跑量为导致赛后髌腱弹性值升高的相关因素[OR值分别为1.511(95%CI:1.022~2.235)和1.226(95%CI:1.093~1.375);均P<0.05]。结论业余马拉松运动员髌腱弹性值更高。SWE可以动态观察髌腱在运动中的变化,为运动员科学训练及避免运动损伤提供有益帮助。Objective To analyze the changes of patellar tendon elasticity quantitatively of amateur marathon runners by shear wave elastography(SWE)in a half marathon.Methods A total of 47 amateur marathon runners(31 males and 16 females,aged from 20 to 44 years)were enrolled as the marathon group,and divided into dominant side(47 patellar tendons)and non‐dominant side(47 patellar tendons).Grey‐scale ultrasound and SWE were performed on the bilateral patellar tendons before and after the half marathon within 2 h and after a period of 1 week.Thirty healthy volunteers(18 males and 12 females,aged from 22 to 39 years)were enrolled as the control group,the SWE‐values derived from the patellar tendon were collected and analyzed.Multivariate logistic regression was performed to analyze the relationship between the changes of SWE‐values and running age as well as weekly amount of running.Results None of any runners showed knee pain and sports injury during the test.The dominant side had a higher SWE‐values than non‐dominant side in marathon group before running[(55.1±15.7)kPa vs(43.8±15.9)kPa,P<0.05].The marathon group had higher SWE‐values than the control group both in dominant side[(55.1±15.7)kPa vs(18.5±3.7)kPa]and non‐dominant side[(43.8±15.9)kPa vs(17.4±3.2)kPa],respectively,before running(P<0.05).The SWE‐values increased significantly both in dominant side[(80.2±23.2)kPa vs(55.1±15.7)kPa]and non‐dominant side[(76.5±26.6)kPa vs(43.8±15.9)kPa]2 h after running in marathon group.After a week,the SWE‐values were not statistically different from those before running(P>0.05).Multivariate logistic regression showed that running age and weekly amount of running were related factors leading to the increase of SWE‐values after running.Conclusions The patellar tendon of amateur marathon runners has higher SWE‐values.SWE can dynamically evaluate the changes of patellar tendon during exercise and is helpful for runners in scientific training and avoiding sports injury.

关 键 词：运动医学 超声 剪切波弹性成像 髌腱 马拉松 

分 类 号：R686.1[医药卫生—骨科学] G822.8[医药卫生—外科学]