膝骨性关节炎女性快速力量训练前后的肌肉MRI定量研究  

Quantitative MRI assessment of muscles in women with knee osteoarthritis before and after high-speed power training

作　　者：屈瑾[1] 李文静 孙焱[2] 展影[1] 雷新玮[1] QU Jin;LI Wenjing;SUN Yan;ZHAN Ying;LEI Xinwei(Department of Radiology,Tianjin First Central Hospital,Tianjin 300192,China;Department of Radiology,Tianjin Children’s Hospital)

机构地区：[1]天津市第一中心医院放射科,天津300192 [2]天津市儿童医院放射科

出　　处：《国际医学放射学杂志》2023年第4期390-395,401,共7页International Journal of Medical Radiology

基　　金：天津市卫生健康科技项目(KJ20099)。

摘　　要：目的探讨女性膝骨性关节炎(KOA)病人股四头肌结构、功能及KOA严重程度的相关性,研究快速力量训练后肌肉结构、功能及KOA症状的改变,及其可能机制。方法前瞻性招募21例女性KOA病人,平均年龄(62.8±4.0)岁,将其随机分为训练组(11例)和对照组(10例),训练组进行12周股四头肌快速力量训练。所有病人于基线及12周后进行定量MRI,测量股四头肌截面积(CSA)和脂肪分数(FF),同时测量肌力(功率、峰力矩),评估下肢活动能力(爬梯功率)及KOA临床症状(WOMAC评分)。基线时行膝关节MRI检查并采用全器官MRI评分(WORMS评分)评估影像学退变程度。采用t检验、Mann-WhitneyU检验或Wilcoxon符号秩检验比较基线时2组间以及每组中基线和随访间股四头肌结构、功能参数及KOA评价指标。采用Spearman或Pearson相关分析股四头肌特征与KOA评价指标以及股四头肌特征间的相关性。结果股四头肌CSA与爬梯功率呈正相关,与WOMAC评分呈负相关;股四头肌FF与WOMAC评分、WORMS评分呈正相关;股四头肌功率与WOMAC评分、WORMS评分呈负相关,与爬梯功率呈正相关;股四头肌峰力矩与WOMAC评分呈负相关,与爬梯功率呈正相关;股四头肌CSA与功率、峰力矩呈正相关,FF与功率、峰力矩呈负相关(均P<0.05)。基线时2组间股四头肌结构、功能及WOMAC评分差异均无统计学意义(均P>0.05)。训练组中随访较基线时股四头肌FF、WOMAC评分降低,爬梯功率增加(均P<0.05);对照组中基线和随访间各项指标的差异均无统计学意义(均P>0.05)。结论股四头肌大小和脂肪浸润与女性KOA症状、肌力和下肢运动能力间存在相关性。快速力量训练能有效缓解KOA症状,改善下肢运动功能,减少肌肉脂肪浸润。Objective To investigate the correlation between the quadriceps muscle structure,function,and severity of knee osteoarthritis(KOA)in female patients with KOA,and to study the changes in muscle structure,function,KOA symptoms after high-speed power training,and explore the underlying mechanisms.Methods A total of twenty-one female KOA patients with a mean age of(62.8±4.0)years were prospectively recruited and randomly assigned to either a training group(11 patients)or a control group(10 patients).The training group underwent 12 weeks of quadriceps high-speed power training.Quantitative MRI was performed at baseline and after 12 weeks to measure quadriceps cross-sectional area(CSA)and fat fraction(FF).Muscle strength(power and peak torque),lower-limb motor function(stair climbing power),and clinical symptoms of KOA(WOMAC score)were also evaluated.Knee MRI was performed at baseline and the degree of radiographic degeneration was assessed using the WORMS score.The t-test,Mann-Whitney U test,or Wilcoxon signed-rank test were used to compare the quadriceps structural and functional parameters and KOA evaluation indexes between the two groups at baseline,and between baseline and follow-up in each group.Spearman or Pearson correlation was used to analyze the correlation between quadriceps characteristics and KOA evaluation indexes and quadriceps characteristics.Results Quadriceps CSA showed a positive correlation with stair climbing power and a negative correlation with WOMAC scores.Quadriceps FF exhibited a positive correlation with WOMAC scores and WORMS scores.Quadriceps power was negatively correlated with WOMAC scores and WORMS scores,and positively correlated with stair climbing power.Quadriceps peak torque was negatively correlated with the WOMAC score and positively correlated with stair climbing power.Quadriceps femoris CSA was positively correlated with power and peak torque,while FF was negatively correlated with power and peak torque(all P<0.05).There were no statistically significant differences in quadrice

关 键 词：膝骨性关节炎 股四头肌 脂肪浸润 定量磁共振成像 肌力 快速力量训练 女性 

分 类 号：R684.3[医药卫生—骨科学] R445.2[医药卫生—外科学]