老年高脂血症患者他汀相关肌病的多模态超声特征分析  

Analysis of multimodal ultrasound characteristics of statin-related myopathy in elderly patients with hyperlipidemia

作　　者：蒋文莉[1] 吴猛[2] 邹彤[3] 李孟璞 范小晶[1] 郭发金[1] Jiang Wenli;Wu Meng;Zou Tong;Li Mengpu;Fan Xiaojing;Guo Fajin(Department of Ultrasound,Beijing Hospital,National Center of Gerontology Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Department of Ultrasound,Zhongnan Hospital of Wuhan University,Wuhan 430071,China;Department of Cardiovascular Medicine,Beijing Hospital,National Center of Gerontology Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院超声医学科,国家老年医学中心,中国医学科学院老年医学研究院,北京100730 [2]武汉大学中南医院综合超声医学科,武汉430071 [3]北京医院心内科,国家老年医学中心,中国医学科学院老年医学研究院,北京100730

出　　处：《中华老年医学杂志》2022年第5期539-543,共5页Chinese Journal of Geriatrics

基　　金：北京医院院级临床课题(BJ-2019-158);湖北省自然科学基金面上项目(2020CFB729);湖北省卫键委青年人才项目(WJ2021Q044);中国医师协会超声医师分会科技新星项目B类(KJXX2020002)

摘　　要：目的探讨老年高脂血症他汀相关肌病患者的多模态超声表现特征,为无创定量评估他汀肌病新方法提供依据。方法选择我院就诊高脂血症老年他汀肌病患者20例(他汀肌病组)、服用他汀类药物未出现他汀肌病老年患者20例(他汀无肌病组)、与上述两组年龄性别相匹配的健康志愿者20例(对照组)。应用二维超声、剪切波弹性成像技术及超微血管成像技术分别获取各组内侧腓肠肌在松弛、背屈、跖屈状态下肌肉的厚度、回声、羽状角、剪切波速度值(SWV)、血管指数(VI)等,并进行对比分析。结果三组的年龄、身高、体重、体质指数等一般情况差异无统计学意义(均P>0.05)。他汀肌病组内侧腓肠肌厚度约(1.04±0.20)cm,小于他汀无肌病组(1.34±0.16)cm和对照组(1.35±0.15)cm(F=22.03,P<0.001)。他汀肌病组羽状角约(12.50±1.10)°,小于他汀无肌病组(18.55±1.28)°和对照组(18.60±1.35)°(F=158.03,P<0.001)。与他汀无肌病组和对照组相比,他汀肌病组静息、背取、跖屈状态下SWV均减小(F=61.71、111.96、8.69,均P<0.01)。他汀肌病组VI值(0.43±0.12)%,小于他汀无肌病组(0.75±0.20)%和对照组(0.93±0.17)%(F=48.93,P<0.001)。而他汀无肌病组和健康对照组之间各指标差异无统计学意义(均P>0.05)。结论多模态超声图像具有一定的特征,可以作为评估高脂血症老年人他汀肌病肌肉损害的一种新评估方法。Objective To investigate the characteristics of multimodal ultrasound imaging in elderly hyperlipidemia patients with statin-related myopathy and to provide a reference of new method for non-invasive quantitative evaluation on statin myopathy.Methods We collected 20 elderly hyperlipidemia patients with statin-related myopathy(the statin-related myopathy group),20 elderly hyperlipidemia patients without statin-related myopathy after taking statins during the same period(the non-statin-related myopathy group),and 20 healthy volunteers who matched the age and sex of the above two groups during the same period(the healthy control group)in our hospital.Two-dimensional ultrasound,shear wave elastography and superb microvascular imaging were used to obtain thickness,echo,pinnation angle and shear wave velocity(SWV)values as well as vascular index(VI)values of the medial gastrocnemius during relaxation,dorsiflexion,and plantar flexion for each group,which were then analyzed.Results There were no significant differences among the three groups in general conditions such as age,height,weight,and body mass index(all P>0.05).The mean thickness of the medial gastrocnemius in the statin-related myopathy group was about(1.04±0.20)cm,which was less than(1.34±0.16)cm in the non-statin-related myopathy group and(1.35±0.15)cm in the healthy control group(F=22.03,P<0.001).The pinnation angle in the statin-related myopathy group was about(12.50±1.10),which was less than(18.55±1.28)in the non-statin-related myopathy group and(18.60±1.35)in the healthy control group(F=158.03,P<0.001).Compared with the non-statin-related myopathy group and the healthy control group,SWV during resting,dorsiflexion and plantar flexion in the statin-related myopathy group decreased(F=61.71,111.96 and 8.69,respectively,P<0.01).The average value of VI in the statin-related myopathy group was about(0.43±0.12)%,which was less than that in the non-statin-related myopathy group(0.75±0.20)%and in the healthy control group(0.93±0.17)%(F=48.93,P<0.001).Howe

关 键 词：他汀相关肌病 羽状角 剪切波 超微血管成像 高脂血症 超声检查 

分 类 号：R589.2[医药卫生—内分泌]