中枢敏化与全膝关节置换术后西安大略和麦克马斯特大学骨关节炎指数的关系研究  

A Study on the Relationship between Central Sensitization and the Western Ontario and McMaster Universities Osteoarthritis Index after Total Knee Arthroplasty

作　　者：吴浩东 郭一顺 徐超[2,4] 姚舒馨 包焕利[2] 尚磊 马建兵 Wu Haodong;Guo Yishun;Xu Chao;Yao Shuxin;Bao Huanli;Shang Lei;Ma Jianbing(School of Medicine,Yan’an University,Yan’an 716000,China;Department of Knee Joint Surgery,Honghui Hospital,Xi’an Jiaotong University,Xi’an 710054,China;Xi’an Medical University,Xi’an 710021,China;Department of Health Statistics,Faculty of Preventive Medicine,The Air Force Military Medical University,Xi’an721032,China)

机构地区：[1]延安大学医学院,陕西延安716000 [2]西安交通大学附属红会医院膝关节病区,陕西西安710054 [3]西安医学院,陕西西安710021 [4]空军军医大学军事预防医学系军队卫生统计学教研室,陕西西安721032

出　　处：《实用骨科杂志》2025年第2期126-131,共6页Journal of Practical Orthopaedics

基　　金：国家自然科学基金面上项目(82173627);陕西省创新人才推进计划(2023-CX-TD-73);陕西省重点研发计划项目(2023-YBSF-464);西安市卫健委面上培育项目(2024ms10);教育部人文社会科学项目(24YJAZH032);西安市卫健委一般研究项目(2023yb30)。

摘　　要：目的探究中枢敏化(central sensitization,CS)与全膝关节置换术(total knee arthroplasty,TKA)术后西安大略和麦克马斯特大学(the Western Ontario and McMaster Universities,WOMAC)骨关节炎指数之间的关系。方法这项前瞻性研究纳入了2022年2月至2023年2月在西安交通大学附属红会医院接受初次单侧TKA的180例患者,男53例,女127例;年龄50~79岁,平均(64.8±5.9)岁。使用中枢敏化量表(central sensitization inventory,CSI)的A部分来评估术前CS。评估术前CSI与术后1年WOMAC评分之间的相关性,以及术后WOMAC评分与术前CSI严重程度之间的关联。此外,还评估了不同CSI严重程度与WOMAC评分各维度之间的关系。结果29例患者(16.1%)在术前有CS,术前CSI与术后WOMAC评分呈正相关(r=0.607,P<0.001)。术前CSI严重程度为中度或更高的患者,术后WOMAC评分显著高于术前CSI严重程度为亚临床或轻度的患者(P<0.001)。与亚临床组相比,中度或更高CSI严重程度的WOMAC评分各个维度得分显著较高(P<0.001)。结论术前CSI与TKA术后1年WOMAC评分呈显著正相关,对术前CS患者进行干预有助于改善TKA后的临床效果。Objective To investigate central sensitization(CS)and relationship with the Western Ontario and McMaster Universities(WOMAC)osteoarthritis index following total knee arthroplasty(TKA).Methods This prospective study included 180 patients who underwent primary unilateral TKA at the Honghui Hospital affiliated with Xi’an Jiaotong University from February 2022 to February 2023.The study comprised 53 males and 127 females,with ages ranging from 50 to 79 years,and a mean age of(64.8±5.9)years.Preoperative CS was assessed using Part A of the central sensitization inventory(CSI).The correlation between preoperative CSI and postoperative WOMAC was evaluated one year after surgery,as well as the association between postoperative WOMAC and the severity of preoperative CSI.Additionally,the relationship between different levels of CSI severity and each dimension of WOMAC was also assessed.Results A total of 29 patients(16.1%)exhibited CS prior to surgery.A positive correlation was observed between the preoperative CSI score and the postoperative WOMAC score(r=0.607,P<0.001).In patients with moderate or higher preoperative CSI severity,the postoperative WOMAC score was significantly higher than that observed in patients with preoperative CSI severity of subclinical or mild(P<0.001).In comparison to the subclinical group,WOMAC scores were found to be significantly higher in each dimension of moderate or higher CSI severity(P<0.001).Conclusion There was a significant positive correlation between preoperative CSI scores and WOMAC scores one year after TKA.Interventions for patients with preoperative CS may help improve clinical outcomes after TKA.

关 键 词：中枢敏化 西安大略和麦克马斯特大学骨关节炎指数 疼痛 全膝关节置换术 

分 类 号：R687.42[医药卫生—骨科学]