肩峰下间隙与肩峰撞击综合征相关性研究

Correlative study of subacromial space and acromial shoulder impingement syndrome

目的 探讨肩峰下间隙与肩峰撞击综合征（SIS）的相关性.方法 回顾性分析40例经临床证实的SIS患者临床及影像资料.对肩峰形态及肩袖损伤进行分型,测量肩峰下间隙.结果 40例患者中,肩峰平坦形（Ⅰ型）9例、弧形（Ⅱ型）12例、钩状（Ⅲ型）19例,肩峰下间隙狭窄32例（＜1 cm）,其中18例＜0.5 cm,冈上肌腱钙化7例,肩锁关节骨质增生10例.肩袖损伤Ⅰ级17例、Ⅱ级15例、Ⅲ级18例,肩峰下滑囊增厚6例,肩峰下-三角肌下囊积液5例,肩关节囊积液10例,冈上肌的萎缩3例,关节孟唇的撕裂2例,孟肱关节不稳定4例.X线检查与MRI检查间肩峰下间隙值差异无统计学意义（P =0.137 0）.肩峰下间隙值与肩袖损伤MRI分级呈正相关（r=0.545,P=0.000 1）.结论 肩峰下间隙与SIS存在一定相关性,可根据肩峰下间隙狭窄程度对SIS进行诊断和分类.

Objective To investigate the correlation between subacromial space and acromial shoulder im- pingement syndrome（SIS）. Methods The clinical and imaging data of 40 patients with SIS were collected and retro- spectively reviewed. The shape of acromion and tears of rotator cuff of all patients were classified. A cromion-Humerus （A-H） distance was measured. Results Among 40 patients, there were 9 cases of type I, 12 cases of type 1I , 19 ca- ses of type m. 32 patients had subacromial space narrowing. 7 cases had calcification in the supraspinatus tendon and 10 patients bad acromioclavicular joint ostcoarthritis. There were 17 cases of type I, 15 cases of type I] , 18 cases of type llI of tears of rotator cuff. 6 patients had subacromial bursa thickening,5 patients had subacromial-dehoid sac flu- id and 10 patients had the joint capsule fluid. 2 patients had jointlabrum avulsion, 3 patients had the supraspinatus muscle atrophy and 4 patients had Bankart Lesion. There was no significant difference was found in A-H distance measured with X-ray and MRI（P = 0. 137 0）. There was positive correlation between the A-H distance and class of rotator cuff（r = 0. 545, P -- 0. 000 1 ）. Conclusion There exists some correlation between subacromial space and SIS. The diagnosis and class of SIS can be assessed according to narrowing range of subacromial space.