摘要
目的探讨二维超声联合剪切波弹性成像在老年肌少症诊断及疗效预测中的临床应用价值。方法选取我院收治的84例老年肌少症患者(观察组)和同期42例健康老年人(对照组),两组均行二维超声和剪切波弹性成像检查,比较两组肌肉厚度、羽状角、肌束长度及收缩状态下腓肠肌杨氏模量平均值(以下简称杨氏模量值)的差异。观察组患者行常规药物治疗和弹力带训练,记录其治疗后总有效率,比较入院时与干预1、3、6个月后握力、四肢骨骼肌指数(ASMI)、简易躯体能力测试表(SPPB)评分的差异。绘制受试者工作特征(ROC)曲线分析二维超声和剪切波弹性成像参数单独及联合应用对老年肌少症诊断和疗效预测的效能。结果观察组肌肉厚度、羽状角、肌束长度及杨氏模量值均低于对照组,差异均有统计学意义(均P<0.05)。观察组患者治疗后总有效率86.90%(73/84);干预1、3、6个月后握力、ASMI、SPPB评分均高于入院时,差异均有统计学意义(均P<0.001)。ROC曲线分析显示,肌肉厚度、羽状角、肌束长度、杨氏模量值诊断老年肌少症的曲线下面积(AUC)分别为0.775、0.716、0.621、0.749,各参数联合应用的AUC为0.911,高于其单独应用,差异均有统计学意义(均P<0.05);肌肉厚度、羽状角、肌束长度、杨氏模量值预测老年肌少症疗效的AUC分别为0.805、0.846、0.785、0.775,各参数联合应用的AUC为0.889,高于单独应用,差异均有统计学意义(均P<0.05)。结论二维超声联合剪切波弹性成像在老年肌少症诊断及疗效预测中均有较好的临床应用价值,可为临床评估提供参考。
Objective To investigate the clinical application value of two-dimensional ultrasound combined with shear wave elastography in the diagnosis and therapeutic efficacy prediction of senile sarcopenia.Methods Eighty-four senile patients with sarcopenia diagnosed and treated in our hospital were selected as the observation group,while 42 healthy elderly patients during the same period were selected as the control group.Two-dimensional ultrasound and shear wave elastography were performed to obtain the muscle thickness,pennation angle,muscle bundle length and Young’s modulus under contracted condition.The total effective rate after routine medicine treatment and elastic band training was recorded,the differences of the score of grip strength,appendicular skeletal muscle mass index(ASMI)and simple physical performance battery(SPPB)at admission and 1,3 and 6 months after intervention were compared.Receiver operating characteristic(ROC)curve was drawn to analyze the efficacy of two-dimensional ultrasound and shear wave elastography parameters used alone and in combined in the diagnosis and therapeutic efficacy prediction of senile sarcopenia.Results The muscle thickness,pennation angle,muscle bundle length and Young’s modulus in the observation group were lower than those in the control group(all P<0.05).The total effective rate of senile sarcopenia after treatment was 86.90%(73/84).The scores of grip strength,ASMI and SPPB at 1,3 and 6 months after intervention were higher than those at admission,the differences were statistically significant(all P<0.05).ROC curve analysis showed that the area under the curve(AUC)of muscle thickness,pennation angle,muscle bundle length and Young’s modulus for diagnosing senile sarcopenia were 0.775,0.716,0.621,0.749,respectively,and the AUC of their combined application was 0.911,which was higher than application alone,the differences were statistically significant(all P<0.05).The AUC of muscle thickness,pennation angle,muscle bundle length and Young’s modulus for predicting the efficacy of senile sarcopenia were 0.805,0.846,0.785,0.775,respecitvely,and the AUC of their combined application was 0.889,which was higher than application alone,and differences were statistically significant(all P<0.05).Conclusion Two-dimensional ultrasound combined with shear wave elastography has better clinical value in the diagnosis and therapeutic efficacy prediction of senile sarcopenia,which can provide reference for clinical evaluation.
作者
刘伟
张建蕾
刘宇
曹光明
景磊
LIU Wei;ZHANG Jianlei;LIU Yu;CAO Guangming;JING Lei(Yan’an University School of Medicine,Shaanxi 716000,China)
出处
《临床超声医学杂志》
CSCD
2024年第3期239-243,共5页
Journal of Clinical Ultrasound in Medicine
关键词
超声检查
二维
剪切波弹性成像
老年
肌少症
疗效预测
Ultrasonography,two-dimensional
Shear wave elastography
Old age
Sarcopenia
Therapeutic efficacy prediction
