中老年女性早期膝骨关节炎的肌肉结构参数特征分析

Characterastics of muscle architectural parameters for early knee osteoarthritis in middle-aged and elderly women

目的通过肌骨超声评估中老年女性早期膝骨关节炎(KOA)膝周肌肉的结构参数变化,明确影响早期KOA的肌肉指标。方法2022年1月至8月,于北京博爱医院分别招募20例健康中老年女性(对照组)和20例单侧早期KOA中老年女性(KOA组),采用肌骨超声测量腘肌厚度、股四头肌厚度和羽状角;其中,股四头肌分别测量股直肌、股中间肌、股外侧肌、股内长肌和股内斜肌。结果与KOA组健侧及对照组优势侧相比,KOA组患侧股内长肌、股内斜肌和腘肌厚度变薄(t>2.133,P<0.05),股内斜肌与股外侧肌比值变小(t>3.660,P<0.01)。与对照组匹配优势侧相比,KOA组患侧股内长肌羽状角变小(t=3.101,P<0.05)。Logistic回归分析表明,股内斜肌厚度(OR=0.235,95%CI 0.068~0.805,P=0.021)和腘肌厚度(OR=0.387,95%CI 0.152~0.980,P=0.045)与早期KOA发病有关。结论中老年女性早期KOA患侧表现出股内长肌、股内斜肌、腘肌厚度变薄,股内斜肌和股外侧肌力量失衡。股内斜肌和腘肌厚度是KOA发病的保护因素。

Objective To observe the architectural parameter changes of the muscles around the knee in middle-aged and elderly women with early knee osteoarthritis(KOA)by musculoskeletal ultrasound,and to clarify the indicators of muscles that affect early KOA.Methods From January to August,2022,20 healthy middle-aged and elderly healthy women(controls)and 20 middleaged and elderly women with unilateral early KOA(KOA group)were recruited through Beijing Bo'ai Hospital,to measure muscle thickness of the popliteus muscle,the muscle thickness and the pennation angle of the quadriceps,as rectus femoris,vastus intermedius,vastus lateralis,vastus medialis longus and vastus medialis oblique.Results Compared with the healthy limb of KOA group,and the controls,the muscle thickness of vastus medialis longus,vastus medialis oblique and popliteus muscle of the affected limb of KOA group became thinner(t>2.133,P<0.05);the proportion of thickness of vastus medialis oblique to thickness of vastus lateralis became smaller(t>3.660,P<0.05).The pennation angle was smaller in the affected limb of KOA group than in the matched dominant side of the controls(t=3.101,P<0.05).Logistic regression analysis showed that the muscle thickness of vastus medialis oblique(OR=0.235,95%CI 0.068 to 0.805,P=0.021)and popliteus muscle(OR=0.387,95%CI 0.152 to 0.980,P=0.045)were related to the onset of early KOA.Conclusion The thickness of vastus medialis longus,vastus medialis oblique and popliteus muscle decrease,and the balance of the strength of vastus medialis oblique and vastus lateralis weakens in the affected limbs of the middleaged and elderly women with early KOA.The thickness of vastus medialis oblique and popliteus muscle are protective factors for onset of KOA.