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脑性瘫痪患者股骨软骨厚度的超声评估。

Ultrasonographic Assessment of Femoral Cartilage Thickness in Patients With Cerebral Palsy.

机构信息

Gaziler Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey; Gaziler FTR EA Hastanesi, 06530, Bilkent Ankara, Turkey.

Department of Physical Medicine and Rehabilitation, Gülhane School of Medicine, University of Health Sciences, Ankara, Turkey.

出版信息

PM R. 2018 Feb;10(2):154-159. doi: 10.1016/j.pmrj.2017.07.002. Epub 2017 Jul 17.

Abstract

BACKGROUND

Cerebral palsy (CP) is one of the most disabling syndromes in children. To our knowledge, there has not yet been any reported evaluation by ultrasonography of the effect of CP on distal femoral cartilage. The value of understanding this effect on cartilage is that sonographic evaluation of cartilage thickness may help physicians to predict the joint health of these children.

OBJECTIVE

To determine whether femoral cartilage thickness in patients with CP is different from that in healthy control subjects.

DESIGN

Cross-sectional study.

SETTING

National tertiary rehabilitation center.

PATIENTS

The study included 40 patients with diplegic CP (23 male and 17 female) and 51 healthy control subjects (29 male and 22 female).

METHODS

Demographic and clinical characteristics were recorded. Cartilage thicknesses were measured.

MAIN OUTCOME MEASURE

Cartilage thickness measurements were taken from the medial and lateral condyles, and intercondylar areas of both knees.

RESULTS

Both groups were similar in terms of age, gender, and weight (P > .05). The mean cartilage thickness measurements of the medial condyle and intercondylar area of knees in the CP group were significantly less than those in the healthy control group (all P < .05). There was moderate negative correlation between age and all femoral cartilage thickness measurements in the CP group. There was no correlation between age and femoral cartilage thickness measurements in the healthy group. There was a negative correlation between Gross Motor Functional Classification System levels and cartilage thickness in the CP group. The highest cartilage thickness measurements were detected in level 1 patients, and the lowest measurements were detected in level 5 patients.

CONCLUSION

This study showed that patients with CP have a thinner femoral cartilage than healthy control subjects. Management of patients with CP should include close surveillance.

LEVEL OF EVIDENCE

III.

摘要

背景

脑瘫(CP)是儿童最致残的综合征之一。据我们所知,目前还没有任何关于超声评估 CP 对股骨远端软骨影响的报道。了解这种软骨影响的价值在于,软骨厚度的超声评估可能有助于医生预测这些儿童的关节健康。

目的

确定 CP 患者的股骨软骨厚度是否与健康对照组不同。

设计

横断面研究。

地点

国家三级康复中心。

患者

研究纳入 40 例双瘫 CP 患者(男 23 例,女 17 例)和 51 例健康对照组(男 29 例,女 22 例)。

方法

记录人口统计学和临床特征。测量软骨厚度。

主要观察指标

测量双膝的内侧和外侧髁以及髁间区的软骨厚度。

结果

两组在年龄、性别和体重方面相似(P >.05)。CP 组的内侧髁和膝关节间区软骨厚度的平均值明显小于健康对照组(均 P <.05)。CP 组中所有股骨软骨厚度测量值与年龄均呈中度负相关。健康组中年龄与股骨软骨厚度测量值无相关性。CP 组的粗大运动功能分类系统(GMFCS)水平与软骨厚度呈负相关。CP 组中,GMFCS 水平 1 患者的软骨厚度最高,GMFCS 水平 5 患者的软骨厚度最低。

结论

本研究表明,CP 患者的股骨软骨比健康对照组薄。CP 患者的管理应包括密切监测。

证据等级

III 级。

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