肌骨超声与血清CRP、MMP⁃3及COMP在评估大腿肌肉拉伤恢复中的作用  

The role of musculoskeletal ultrasound and serum CRP, MMP⁃3 and COMP in evaluating the recovery of thigh muscle strain

作　　者：朱文峰 朱娜 崔蕾 李维芝 ZHU Wenfeng;ZHU Na;CUI Lei;LI Weizhi(Department of Ultrasound Diagnosis,Xianyang Central Hospital,Xianyang,Shaanxi,China,712000)

机构地区：[1]咸阳市中心医院超声诊断科,陕西咸阳712000

出　　处：《分子诊断与治疗杂志》2024年第11期2121-2124,2129,共5页Journal of Molecular Diagnostics and Therapy

基　　金：陕西省重点研发计划项目(S2017⁃ZDYF⁃YBXM⁃SF⁃0541)。

摘　　要：目的探讨肌骨超声与血清CRP、MMP⁃3及COMP在评估大腿肌肉拉伤恢复中的应用价值。方法选取2022年4月至2023年6月于咸阳市中心医院运动与关节科、手足外科就诊并确诊为大腿肌肉拉伤的94例患者作为研究对象。采用肌肉力量评分、关节活动度为分组依据,划分为恢复良好组、恢复不良组。比较两组一般资料、肌骨超声表现及血清CRP、MMP⁃3及COMP水平。使用二元Logistic回归模型分析影响大腿肌肉拉伤恢复不良的危险因素;绘制ROC曲线,计算AUC,评估肌骨超声与血清CRP、MMP⁃3及COMP在评估大腿肌肉拉伤恢复中的应用价值。结果94例大腿肌肉拉伤患者中,恢复良好组为76例(80.85%)、恢复不良组为18例(19.15%),两组性别、年龄、损伤程度及部位比较,差异无统计学意义(P>0.05)。恢复不良组肌肉纹理模糊、肌肉纤维连续性较差、瘢痕/纤维化程度高占比、血清CRP、MMP⁃3及COMP水平显著高于恢复良好组,差异具有统计学意义(P<0.05)。经二元Logistic回归模型,可见肌肉纹理模糊、肌肉纤维连续性较差、瘢痕/纤维化程度高、血清CRP、MMP⁃3及COMP水平升高是影响大腿肌肉拉伤恢复不良的危险因素(P<0.05)。肌骨超声与血清CRP、MMP⁃3及COMP联合评估大腿肌肉拉伤恢复的AUC(95%CI)、敏感度及特异度分别为0.934(0.857~0.972)、90.25%及92.78%,显著高于肌骨超声与血清CRP、MMP⁃3及COMP单一评估的应用价值(P<0.05)。结论肌骨超声与血清CRP、MMP⁃3及COMP在评估大腿肌肉拉伤恢复中均具有重要价值,且联合评估可更准确判断大腿肌肉拉伤的恢复状况,为临床决策提供有力支持。Objective To explore the application value of musculoskeletal ultrasound and serum CRP,MMP⁃3 and COMP in evaluating the recovery of thigh muscle injury.Methods From April 2022 to June 2023,94 patients diagnosed with thigh muscle strain were selected as the research subjects.They were divided into two groups based on their muscle strength score and joint mobility:the good recovery group and the poor recovery group.General data,musculoskeletal ultrasound findings and serum CRP,MMP⁃3 and COMP levels were compared between the two groups.A binary logistic regression model was used to analyze the risk factors affecting the poor recovery of thigh muscle strain.An ROC curve was drawn,the AUC was calculated,and the value of musculoskeletal ultrasound and serum CRP,MMP⁃3,and COMP in evaluating the recovery of thigh muscle injury was assessed.Results Among the 94 patients with thigh muscle strain,76 cases(80.85%)were in the good recovery group,while 18 cases(19.15%)were in the poor recovery group.There was no significant difference in gender,age,degree of injury and location between the two groups(P>0.05).The muscle texture blur,poor muscle fiber continuity,high proportion of scar/fibrosis degree,serum CRP,MMP⁃3,and COMP levels in the poor recovery group were significantly higher than those in the good recovery group,and the differences were statistically significant(P<0.05).The binary logistic regression model showed that blurred muscle texture,poor continuity of muscle fibers,high degree of scar/fibrosis,and elevated serum CRP,MMP⁃3,and COMP levels were risk factors for poor recovery of thigh muscle injury(P<0.05).The AUC(95%CI),sensitivity and specificity of musculoskeletal ultrasound combined with serum CRP,MMP⁃3,and COMP in evaluating the recovery of thigh muscle injury were 0.934(0.857~0.972),90.25%and 92.78%,respectively,which were significantly higher than those of musculoskeletal ultrasound combined with serum CRP,MMP⁃3,and COMP(P<0.05).Conclusion Musculoskeletal ultrasound,serum CRP,MMP⁃3,and COMP

关 键 词：肌骨超声 C反应蛋白 基质金属蛋白酶⁃3 COMP 大腿肌肉拉伤 

分 类 号：R445.1[医药卫生—影像医学与核医学] R685[医药卫生—诊断学]