脑卒中患者小腿肌肉形态结构变化的定量超声研究

A study on quantitative ultrasound on evaluating the architectural parameters of lower leg muscles in stroke survivors

目的:应用定量超声评价脑卒中患者小腿肌肉形态结构的变化。方法:选择30例脑卒中患者和30例正常人,选取踝关节0°(解剖中立位)时,分别在静息状态与最大等长收缩状态下,应用高频超声测量脑卒中患者健侧、患侧和正常人的一侧小腿的胫骨前肌(TA)及腓肠肌内侧头(MG)的形态结构参数,包括羽状角、肌肉厚度及肌纤维长度。结果:静息状态及最大等长收缩状态下,脑卒中患者患侧TA和MG的羽状角和肌肉厚度均较健侧和正常人减小(P<0.05)。静息状态及最大等长收缩状态下,脑卒中患者患侧TA和MG的肌纤维长度均较健侧和正常人长(P<0.05)。而健侧和正常人无显著性差异(P>0.05)。结论:脑卒中后患者TA和MG的形态结构参数发生了改变,超声可量化评估脑卒中患者肌肉结构参数。

Objective: To evaluate the changes of architectural parameters of lower leg muscles in stroke survivors, measured by ultrasound.Method: Thirty stroke survivors and thirty healthy subjects were recruited in this study. When they were at rest and during maximum isometric voluntary contraction(MIVC) respectively, the muscle architectures parameters of tibialis anterior(TA) and medial gastrocnemius(MG) in affected side and unaffected side of stroke survivors and one side of healthy subjects were measured at 0 degrees of ankle joint(anatomic neutrality) by ultrasonography, including the pennation angle, muscle thickness, and fascicle length.Result: At the affected side of stroke survivors, the pennation angle and muscle thickness of TA and MG were less than those at the unaffected side and healthy subjects at rest and during MIVC(P<0.05). Furthermore, at the affected side of stroke survivors, the fascicle length of TA and MG were longer than those at the unaffected side and healthy subjects at rest and during MIVC(P<0.05). But no significant difference was found in the unaffected side and healthy subjects(P>0.05).Conclusion: There are considerable changes in the muscle architecture of TA and MG of post-stroke. Ultrasound can quantitatively evaluate the muscle structure parameters of stroke survivors.