中老年退行性肩袖撕裂患者肩峰指数、肩肱距离与年龄的相关性  

Correlation of acromial index and acromiohumeral distance with age in middle-aged and elderly patients with degenerative rotator cuff tear

作　　者：申勇 刘时璋[1] 翟腾飞 侯双虎 冯敏[1] Shen Yong;Liu Shizhang;Zhai Tengfei;Hou Shuanghu;Feng Min(Department of Orthopedics,Shaanxi Provincial People’s Hospital,Xi’an 710068,Shaanxi Province,China)

机构地区：[1]陕西省人民医院骨科,陕西省西安市710068

出　　处：《中国组织工程研究》2023年第31期5040-5045,共6页Chinese Journal of Tissue Engineering Research

基　　金：陕西省社会发展科技攻关项目(2021SF-251),项目负责人:冯敏。

摘　　要：背景:退行性肩袖撕裂是影响肩关节活动的主要疾病之一,在临床工作中发现中年人的患病数明显增多。其中在肩关节X射线片检查中可以完成肩峰指数及肩肱距离的测量,这两个指标都被明确证实为肩袖撕裂的直接危险因素,主要表现在这两者异常时肩关节活动(尤其外展、上举)时于不同方位加重了肩袖的撞击、损伤、撕裂,但对于中年患者与老年患者之间两种指标是否存在差异且两种指标是否与患者年龄之间存在相关性有待进一步证实。目的:分析中、老年退行性肩袖撕裂患者的肩峰指数及肩肱距离之间是否存在差异,并分析两种指标是否与患者年龄存在相关性。方法:收集2019年4月至2022年6月就诊于陕西省人民医院骨科并诊断为退行性肩袖撕裂的患者64例、非肩袖撕裂患者63例,运用受试者曲线分析确定肩峰指数、肩肱距离的截断值及曲线下面积,按年龄与是否肩袖撕裂分为4组即中年肩袖撕裂组、中年对照组、老年肩袖撕裂组、老年对照组,比较各组患者肩峰指数、肩肱距离的差异以及2种指标与患者年龄之间的相关性。结果与结论:①肩峰指数的曲线下面积为0.710,肩肱距离的曲线下面积为0.706;截断值肩峰指数>0.70,肩肱距离<7.9 mm;②中年肩袖撕裂组的肩峰指数显著大于中年对照组(P=0.013),肩肱距离显著小于中年对照组(P<0.001);老年肩袖撕裂组的肩峰指数显著大于老年对照组(P<0.001),肩肱距离与老年对照组无显著差异(P>0.05);中年肩袖撕裂组的肩峰指数与老年肩袖撕裂组无显著差异(P>0.05),肩肱距离显著小于老年肩袖撕裂组(P<0.001);③肩峰指数与年龄之间不存在负相关关系(r=-0.015,P=0.83);肩肱距离与年龄之间存在正相关关系(r=0.334,P<0.001);④提示肩峰指数、肩肱距离都是退行性肩袖撕裂的危险因素,且中年肩袖撕裂患者的肩峰指数、肩肱距离皆异常于中年对照BACKGROUND:Degenerative rotator cuff tear is one of the main diseases affecting shoulder joint activities.In clinical work,the number of middle-aged patients has increased significantly and measurements of acromial index and acromiohumeral distance can be completed in shoulder X-ray examinations,both of which are clearly expressed as direct risk factors for rotator cuff injury.Abnormalities in these two indexes indicate impingement,injury,and tear of the rotator cuff are aggravated in different directions during shoulder joint activities(especially abduction and lift).Whether there is a difference between the two indicators of middle-aged patients and elderly patients and whether there is a correlation between the two indicators and the patient’s age remain to be further confirmed.OBJECTIVE:To analyze whether there is a difference between the acromion index and acromiohumeral distance between middle-aged and elderly patients with degenerative rotator cuff tear,and to analyze whether the two indicators are correlated with the patient’s age.METHODS:A total of 64 patients diagnosed with degenerative rotator cuff tear and 63 patients with no non-rotator cuff tear were enrolled,who were admitted at Department of Orthopedics of Shaanxi Provincial People’s Hospital from April 2019 to June 2022.Receiver curve analysis was used to determine acromion index,cut-off value of acromiohumeral distance and area under the curve.Then,enrolled patients were divided into four groups according to age and whether or not rotator cuff tear existed:middle-aged tear group,middle-aged control group,elderly tear group,and elderly control group.We compared acromion index and acromiohumeral distance between groups and investigated the correlation between the two indicators and the age of the patients.RESULTS AND CONCLUSION:(1)The area under the curve of the acromion index and the acromiohumeral distance was 0.710 and 0.706,respectively.The cut-off values were>0.70 for the acromion index and<7.9 mm for the acromiohumeral distance.(2)The

关 键 词：退行性肩袖撕裂 肩峰指数 肩肱距离 冈上肌 肩峰下撞击 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R604