膝骨关节炎患者股直肌超声形态特征分析

关键词：膝骨关节炎  股直肌  肌骨超声  形态学  WOMAC评分

Keywords:knee osteoarthritis  rectus femoris  musculoskeletal ultrasound  morphology  WOMAC score

摘要：

      摘要 目的：本研究拟通过对膝骨关节炎（knee osteoarthritis，KOA）患者进行膝关节肌骨超声检测，观察KOA患者股直肌超声形态变化，并分析其与膝关节疼痛、僵硬和日常功能障碍的相关性，为KOA的康复方案制定提供依据。 方法：2019年11月—2020年6月，纳入在福建中医药大学附属人民医院骨伤科门诊和住院的60例单膝患病KOA患者，患膝设为观察组，健膝设为对照组，每组各60个膝关节。所有患者双膝关节均采用超声测量股直肌羽状角、肌肉厚度和横截面积，以及进行西安大略和麦克马斯特大学关节炎指数（The Western Ontario and Mcmaster Universities osteoarthritis index，WOMAC）疼痛、关节僵硬、日常活动评分，并分析观察组股直肌超声检测指标与WOMAC评分数据间的相关性。 结果：观察组股直肌羽状角、肌肉厚度及横截面积均明显小于对照组（P＜0.05）；观察组膝关节WOMAC疼痛、关节僵硬、日常活动评分均高于对照组（P＜0.05）；观察组股直肌羽状角、肌肉厚度及横截面积与WOMAC疼痛、关节僵硬、日常活动评分均呈负相关（P＜0.05）。 结论：KOA患者股直肌肌纤维排列紊乱，发生萎缩，导致膝关节疼痛、僵硬和日常功能障碍，故临床制订康复方案时应注重股直肌病灶的治疗和强化力量训练。

Abstract:

      Abstract Objective： To observe the changes of the ultrasonic morphological and structural characteristics of rectus femoris through knee musculoskeletal ultrasonic examination in KOA patients， and analyze its correlation with knee pain，stiffness and daily dysfunction in KOA patients， so as to provide a basis for the formulation of KOA rehabilitation program. Method： Sixty KOA patients with one knee involvement were divided into observation（affected knee， n=60） and control（healthy knee， n=60） group. Morphology included the pennation angle， muscle thickness and cross-sectional area of rectus femoris were observed by ultrasound and WOMAC， joint stiffness， and daily activities were scored on both knees. Then the correlation between ultrasonic morphological indexes of rectus femoris and WOMAC score data in the observation group was analyzed. Result： In the observation group， the pennation angle， muscle thickness and cross-sectional area of rectus femoris were significantly smaller than those of the control group（P＜0.05）. WOMAC score， joint stiffness score， and daily activities score were all higher than those of the control group（P＜0.05）. The pennation angle， muscle thickness and cross-sectional area of rectus femoris were negatively correlated with WOMAC score， joint stiffness score， and daily activities score（P＜0.05）. Conclusion： In KOA patients， the fibrillar fibers of rectus femoris are disordered and atrophy， which is the reason of pain， stiffness and daily dysfunction of the knee joint. Therefore，more attention should be paid to the treatment of rectus femoris' focus and strength training in the clinical rehabilitation plan.