肩峰-肱骨头间距与肩胛骨长度比评估脑卒中偏瘫患者肩关节半脱位的临床研究

关键词：脑卒中  肩关节半脱位  偏瘫  肩峰-肱骨头间距与肩胛骨长度比

Keywords:stroke  glenohumeral subluxation  hemiplegia  acromio-humeral interval/scapula ratio

摘要：

      摘要 目的：探讨肩峰-肱骨头间距与肩胛骨上下角长度比临床应用的效度及信度，评价该比值评定脑卒中偏瘫患者肩关节半脱位的临床应用价值。 方法：纳入30例健康成年人，计算受试者离平板探测器不同距离下（0cm、50cm）肩关节摄片的肩峰-肱骨头间距与肩胛骨上下角间距比；使用组内系数评估该方法的信度；利用该比值与肩峰-肱骨头间距进行相关分析，探讨该法的效度。计算54例脑卒中偏瘫肩关节半脱位患者患侧肩峰-肱骨头间距与肩胛骨长度比，利用该比值与肩峰-肱骨头间距进行相关分析，探讨该法的临床应用价值。 结果：不同距离下测量的健康成年人肩峰-肱骨头间距与肩胛骨长度比组内相关系数左侧为0.808、右侧为0.820；受试者距离平板探测器0cm下，左、右侧肩峰-肱骨头间距和各自肩峰-肱骨头间距与肩胛骨长度比具有相关性，结果具有显著性意义（左侧：r=0.955，P<0.05，右侧：r=0.944，P<0.05）；受试者距离平板探测器50cm下，左、右侧肩峰-肱骨头间距和各自肩峰-肱骨头间距与肩胛骨长度比具有相关性，结果具有显著性意义（左侧：r=0.828，P<0.05，右侧：r=0.804，P<0.05）。脑卒中偏瘫肩关节半脱位患者半脱位程度和肩峰-肱骨头间距与肩胛骨长度比具有相关性，结果具有显著性意义（r=0.886，P<0.05）。 结论：肩峰-肱骨头间距与肩胛骨上下角长度比具有较好的信度及效度，可用于临床评估脑卒中偏瘫患者肩关节半脱位。

Abstract:

      Abstract Objective： To explore the reliability and validity of "acromio-humeral interval/scapula ratio" in evaluating glenohumeral subluxation (GHS) in stroke patients with hemiplegia. Method： The "acromio-humeral interval/scapula ratio" of 30 healthy adults at different positions away from the flat panel detector was calculated respectively (0cm，50cm). Intraclass correlation coefficient (ICC) was used to evaluate the reliability of this method. The correlation analysis was made to explore the validity of this method between the "acromio-humeral interval/scapula ratio" and acromio-humeral interval. Result： the ICC of acromio-humeral interval/scapula ratio measured at two different distances (0cm，50cm) is left：0.808 or right：0.820. The value of acromio-humeral interval measured by radiation method is correlated with the ratio of 0cm or 50cm away from the flat panel detector， and the results were statistically significant （0cm：left：r=0.955， P<0.05，right：r=0.944， P<0.05）（50cm；left：r=0.828， P<0.05，right：r=0.804， P<0.05）.There is a statistical correlation between the acromio-humeral interval and the ratio in patients with stroke hemiplegia (r=0.886，P<0.05). Conclusion： "Acromio-humeral interval/scapula ratio" has a good reliability and validity， and can be used for clinical evaluation of GHS in stroke hemiplegic patients.