De Jonge S, Warnaars J L F, De Vos R J, Weir A, van Schie H T M, Bierma-Zeinstra S M A, Verhaar J A N, Tol J L
Sports Medicine Department, The Hague Medical Center, Leidschendam, The Netherlands; Department of Orthopedics, Erasmus Medical Center, Rotterdam, The Netherlands.
Scand J Med Sci Sports. 2014 Oct;24(5):773-8. doi: 10.1111/sms.12072. Epub 2013 Apr 22.
Neovascularization is frequently observed in tendinopathy. Previous studies have focused on the role of neovascularization in Achilles tendinopathy, but have been conducted in small series. It is still unclear whether the degree of neovascularization is related to severity of symptoms. The purpose was to study the relationship between ultrasonographic neovascularization and clinical severity in patients with Achilles tendinopathy. In this prospective cohort study, data on 127 patients (141 tendons) were assembled from databases of three clinical trials. All patients followed an eccentric exercise program. The Öhberg neovascularization score (0-4+) and Victorian Institute of Sports Assessment-Achilles (VISA-A) score (split into domains: pain, function and activity) were collected during baseline and follow-up. The relationship between neovascularization and VISA-A score was calculated. At baseline, 107 tendons (76%) showed some degree of neovascularization. In 556 coupled measurements, neovascularization was weakly related to the VISA-A score [Exp (B) 1.017, 95% confidence interval (CI), 1.007-1.026]. No significant relationship was found between neovascularization and the pain domain (P = 0.277) and the activity domain (P = 0.283), but there was between neovascularization and the function domain of the VISA-A score [Exp (B) = 1.067, 95% CI 1.018-1.119]. In conclusion, neovascularization in Achilles tendinopathy is weakly related to clinical severity, mainly based on the function domain of the VISA-A score.
在肌腱病中经常观察到新生血管形成。以往的研究主要关注新生血管形成在跟腱病中的作用，但样本量较小。目前仍不清楚新生血管形成的程度是否与症状的严重程度相关。本研究旨在探讨跟腱病患者超声检查显示的新生血管形成与临床严重程度之间的关系。在这项前瞻性队列研究中，我们从三项临床试验的数据库中收集了127例患者（141条肌腱）的数据。所有患者均接受离心运动训练。在基线和随访期间收集Öhberg新生血管评分（0 - 4+）和维多利亚运动评估-跟腱（VISA-A）评分（分为疼痛、功能和活动三个领域）。计算新生血管形成与VISA-A评分之间的关系。在基线时，107条肌腱（76%）显示出一定程度的新生血管形成。在556次配对测量中，新生血管形成与VISA-A评分呈弱相关[Exp (B) 1.017，95%置信区间（CI），1.007 - 1.026]。新生血管形成与疼痛领域（P = 0.277）和活动领域（P = 0.283）之间未发现显著相关性，但与VISA-A评分的功能领域之间存在相关性[Exp (B) = 1.067，95% CI 1.018 - 1.119]。总之，跟腱病中的新生血管形成与临床严重程度呈弱相关，主要基于VISA-A评分的功能领域。
