| 黄立坚,石军,袁彩娣,等.实时剪切波超声弹性成像在脑卒中后偏瘫患者骨骼肌康复评估中的应用价值[J].中国临床保健杂志,2026,29(2):241-246. |
| 实时剪切波超声弹性成像在脑卒中后偏瘫患者骨骼肌康复评估中的应用价值 |
| The application value of real-time shear wave ultrasound elastography in the rehabilitation assessment of skeletal muscles in post-stroke hemiplegic patients |
| 投稿时间：2026-01-21 |
| DOI：10.3969/J.issn.1672-6790.2026.02.019 |
| 中文关键词: 弹性成像技术 卒中 偏瘫 肌,骨骼 康 |
| 英文关键词: Elasticity imaging techniques stroke Hemiplegia Muscle,skeletal Rehabilitation Fund program:Health Science and Technology Project of Shaoxing,Zhejiang Province |
| 基金项目:浙江省绍兴市卫生健康科技计划项目 |
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| 中文摘要: |
| 目的 探讨实时剪切波超声弹性成像(SWE)在脑卒中后偏瘫患者骨骼肌康复评估中的应用价值。方法 采用前瞻性的研究方法。选取2022年1月至2025年2月绍兴第二医院医共体总院收治的152例脑卒中后偏瘫患者,均接受临床系统性康复治疗(包括运动治疗和电疗法、冷疗法,热疗法等物理因子治疗)。于治疗前及治疗1个月、3个月行健侧及患侧常规灰阶超声及SWE检查,测定上肢三角肌、肱三头肌、肱二头肌及下肢股直肌、腓肠肌、比目鱼肌中段在自然松弛状态下的剪切波传播速度(SWV)及杨氏模量(YM),比较健侧与患侧于治疗前及治疗1个月、3个月的SWV、YM。同时采用Fugl-Meyer运动功能评分(FMA)评估患者患侧肢体运动功能,分析SWE指标与FMA评分的相关性,建立多元线性回归模型,量化SWV、YM对运动功能评分的预测价值。由2名经验丰富的超声医师进行评估一致性验证,计算组内相关系数(ICC)。结果 治疗前,患侧上肢三角肌、肱三头肌、肱二头肌及下肢股直肌、腓肠肌、比目鱼肌的SWV、YM均低于健侧(均P＜0.05)。治疗1个月,患侧上肢三角肌、肱三头肌、肱二头肌及下肢股直肌、腓肠肌、比目鱼肌的SWV、YM均较治疗前升高(均P＜0.05),但仍低于健侧(P＜0.05)。治疗3个月,患侧上肢三角肌、肱三头肌、肱二头肌及下肢股直肌、腓肠肌、比目鱼肌的SWV、YM均较治疗前升高(均P＜0.05),且与健侧差异无统计学意义(P＞0.05)。治疗前、治疗1个月及3个月,患侧各骨骼肌SWV、YM均与FMA评分呈正相关(均P＜0.05)。多元线性回归分析显示,SWV、YM可作为FMA评分的有效预测指标(R2＞0.6,P＜0.05)。结论 SWE可通过定量检测脑卒中后偏瘫患者骨骼肌的SWV、YM,反映患侧骨骼肌在康复治疗过程中的弹性变化,为脑卒中后偏瘫患者骨骼肌功能的动态评估提供客观的影像学依据。 |
| 英文摘要: |
| Objective To explore the application value of real-time shear wave elastography (SWE) in the evaluation of skeletal muscle rehabilitation in patients with post-stroke hemiplegia.Methods Adopt a forward-looking research methodology.A total of 152 patients with post-stroke hemiplegia admitted to the General Hospital of Shaoxing Second Hospital Medical Alliance from January 2022 to February 2025 were selected,all of whom received clinical systematic rehabilitation treatment (including exercise therapy,electrotherapy,cryotherapy,thermotherapy and other physical factor therapies).Routine gray-scale ultrasound and SWE examinations were performed on the healthy and affected sides before treatment,1 month after treatment,and 3 months after treatment.The shear wave velocity (SWV) and Young′s modulus (YM) of the middle segments of the upper limb deltoid,triceps brachii,biceps brachii,and lower limb rectus femoris,gastrocnemius,and soleus muscles in the natural relaxed state were measured.SWV and YM of the healthy side and the affected side were compared before treatment,1 month after treatment,and 3 months after treatment,respectively.At the same time,the Fugl-Meyer Assessment (FMA) was used to evaluate the motor function of the affected limbs of the patients.Correlation analysis between SWE indexes and FMA scores was supplemented,and a multiple linear regression model was established to quantify the predictive value of SWV and YM on motor function scores.Inter-observer consistency verification was performed by 2 experienced ultrasound physicians,and the intraclass correlation coefficient (ICC) was calculated.Results Before treatment,the SWV and YM of the affected upper limb deltoid,triceps brachii,biceps brachii,and lower limb rectus femoris,gastrocnemius,and soleus muscles were lower than those of the healthy side (P<0.05).One month after treatment,the SWV and YM of the affected upper limb deltoid,triceps brachii,biceps brachii,and lower limb rectus femoris,gastrocnemius,and soleus muscles were higher than those before treatment (P<0.05),but still lower than those of the healthy side (P<0.05).Three months after treatment,the SWV and YM of the affected upper limb deltoid,triceps brachii,biceps brachii,and lower limb rectus femoris,gastrocnemius,and soleus muscles were higher than those before treatment (P<0.05),and there was no significant difference compared with the healthy side (P>0.05).Before treatment,1 month and 3 months after treatment,SWV and YM of each skeletal muscle on the affected side were significantly positively correlated with FMA scores (P<0.05).Multiple linear regression analysis showed that SWV and YM could be used as effective predictors of FMA scores (R2>0.6,P<0.05).Conclusions SWE can reflect the elastic changes of the affected skeletal muscles during rehabilitation treatment by quantitatively detecting the SWV and YM of skeletal muscles in patients with post-stroke hemiplegia,providing an objective imaging basis for the dynamic evaluation of skeletal muscle function in patients with post-stroke hemiplegia. |
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