膝骨关节炎常见经筋病灶点剪切波弹性模量研究  

Study on Shear Wave Elastic Modulus of Common Meridian Tendons in Knee Osteoarthritis

作　　者：闫鑫[1] 潘晶晶 陈菲 修宇 王延珍[1] 李珩[1] 周明 张文鹏 何志玲 张书昊 崔峰[3] 吴金鹏[3] Yan Xin;Pan Jingjing;Chen Fei;Xiu Yu;Wang Yanzhen;Li Heng;Zhou Ming;Zhang Wenpeng;He Zhiling;Zhang Shuhao;Cui Feng;Wu Jinpeng(Zibo Central Hospital,Zibo 255000,China;Faculty of Health Sciences and Engineering,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;Institute of Biomedical Engineering,Chinese Academy of Medical Sciences,Tianjin 300192,China)

机构地区：[1]淄博市中心医院,山东淄博255000 [2]天津中医药大学健康科学与工程学院,天津301617 [3]中国医学科学院生物医学工程研究所,天津300192

出　　处：《世界科学技术-中医药现代化》2022年第12期4768-4776,共9页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家科学技术部国家重点研发计划项目(2018YFC1707803):基于中医导引术的传统运动训练及肢体功能评定系统,负责人:吴金鹏。

摘　　要：目的 采用剪切波弹性成像技术(SWE)观察膝骨关节炎(KOA)患者常见经筋病灶点的弹性模量。方法 对41例KOA患者与40名健康受试者,8个经筋病灶点部位进行超声检测,对其弹性模量值进行采集和比较。结果 与正常对照组的筋结点相比,KOA观察组经筋病灶点的弹性模量值均增大(P<0.05);与正常对照组的筋结点比较,患者X线不同分级组经筋病灶点的弹性模量值均增大(P<0.05);X线不同分级患者间的弹性模量值比较,髌内下Ⅰ级组的弹性模量值低于Ⅱ级组和Ⅳ级组;髌外下Ⅰ级组的弹性模量值低于Ⅱ级组;阳陵次Ⅰ级组、Ⅱ级组和Ⅲ级组的弹性模量值低于Ⅳ级组;委中次Ⅱ级组的弹性模量值低于Ⅲ级组(P<0.05);KOA患者髌内下(r=0.417,P=0.007)、成腓间(r=0.431,P=0.005)、阳陵次(r=0.465,P=0.002)和委中次(r=0.426,P=0.005)的弹性模量值与X线分级呈明显正相关。结论 SWE可以量化经筋病灶点的硬度特征,从客观的角度反应了KOA患者病灶点与正常人筋结点的硬度存在差异且显著增大,可为中医触诊提供客观指标,为KOA临床诊断提供新思路。Objective To observe the elastic modulus of common menstrual tendons in patients with knee osteoarthritis(KOA) by shear wave elastography(SWE).Methods Ultrasonic examination was performed in 8 focus sites of 41 patients with KOA and 40 healthy subjects,and the elastic modulus values were collected and compared.Results Compared with the normal control group,the elastic modulus of the focal point of the meridian tendon in the KOA observation group was higher than that in the normal control group(P<0.05),and that in the patients with different X-ray grades was higher than that in the patients with different X-ray grades(P<0.05).Compared with the patients with different X-ray grades,the elastic modulus in the BinNeiXia Ⅰ grade group was lower than that in the Ⅱ grade group and the Ⅳ grade group.The elastic modulus of BinWaiXia I grade group was lower than that of Ⅱ grade group,that of YanglingCi Ⅰ grade group,Ⅱ grade group and Ⅲ grade group was lower than that of Ⅳ grade group,and that of WeiZhongCi Ⅱ grade group was lower than that of Ⅲ grade group(P<0.05).The elastic modulus values of KOA patients in the BinNeiXia,ChengFeiJian,YanglingCi and WeiZhongCi were positively correlated with X-ray grade(r=0.417,P=0.007;r=0.431,P=0.005;r=0.465,P=0.002;r=0.426,P=0.005).Conclusions SWE can quantify the hardness characteristics of meridian tendon lesions,which objectively reflects the difference and significant increase in hardness between KOA patients and normal subjects,which can provide an objective index for TCM palpation and a new idea for clinical diagnosis of KOA.

关 键 词：膝骨关节炎 剪切波弹性超声 经筋病灶点 弹性模量 

分 类 号：R684.3[医药卫生—骨科学]