脊髓型颈椎病手功能评价

Evaluation of impairment of hand function in patients with cervical spondylotic myelopathy

[目的]评价脊髓型颈椎病患者双手功能障碍程度。[方法]明确诊断为脊髓型颈椎病患者131例按年龄30～49岁、50～59岁、60～69岁、70～79岁进行分组，选择年龄、性别及例数均匹配的健康成年人为对照组，采用Duruoz’s Hand Index（DHI）手部功能指数评分法对疾病组及对照组双手功能进行定量评分。患者颈椎病严晕程度评价采用改良JOA评分。采用SPSSI3．0统计软件对疾病组及对照组左右手功能评分进行对比统计分析，对患荷手部功能评分及JOA评分进行Pearson相关分析，检验水准α=0．05。[结果]年龄由低至高4组中，DHI评分均值在Control及CSM组分别为88．6±1．0、82．1±5．6；86．3±1．8、80．2±4．3；80．8±4．8、71．9±6．6；79．4±6．3、62．5±7．4，CSM组DHI评分显著低于对照组，在各年龄组左有手评分及均值二者差异均具有统计学意义（P〈0．001）。CSM组JOA评分在各年龄组分别为13．0±1．8、12．4±1．7、11．7±1．4、10．3±1．4，JOA评分与DHI评分Pearson相关系数分别为0．558、0．497、0．459、0．482（P〈0．05），二者具有相关性。[结论]Duru6z手部功能指数能较客观并定量地评价脊髓型颈椎病手部功能障碍程度。脊髓型颈椎病患者手部功能较正常人明显降低，并与脊髓型颈椎病的严重程度密切相关。

[ Objective] To evaluate hand function in patients with cervical spondylotic myelopathy. [ Method] One hundred ad thirty-one consecutive patients with cervical spondylotic myelopathy（CSM） were divided into four groups with the ages of 30 to 49, 50 -59,60 -69 and 70 -79 years. And 131 healthy volunteers were taken as control group with the same age and sex. Duruoz＇s Hand Index （DHI） was taken to evaluate hand function in the two groups quantitatively. In the CSM group ,JOA Questionnaire was used to evaluate the severity of cervical myelopathy. SPSS statistical software 13.0 was used to evaluate the DHI difference between CSM and control groups. Pearson correlation was analyzed between the DHI and JOA scores in the CSM group. [ Result] The DHI scores were 88.6 ± 1.0,82. 1 ±5.6,86.3 ± 1.8,80.2 ±4.3,80.8 ＋4.8,71.9 ±6.6,79.4 ±6.3 and 62.5 ±7.4 in the control and CSM groups respectively. The DHI seores in CSM group were significantly lower than in control group.The differenee was slatislial ly significant （P 〈 0. 001 ）. The JOA scores were 13.0 ± 1.8,12.4 ±1. 7,11.7 ±1.4,10.3 ± 1.4 in every CSM age group. The Pear- son coefficient correlation were 0. 558 ,0. 497 ,0. 459 and 0.482 （P 〈 0.05） between the JOA and DHI scores in CSM group. Conclusion] Duruoz Hand Index can be used to evaluate the hand function in patiens with CSM quantitatively and objectively,DHI scores are lower in patients with CSM than in the controls,whieh is correlated with the severity of cervical myelopathy.