剪切波速度预测颈肩肌筋膜疼痛综合征复发的价值-现代医学

剪切波速度预测颈肩肌筋膜疼痛综合征复发的价值

单位：复旦大学附属华山医院北院宝山分院超声科, 上海 200431

分类号：R445.1

出版年·卷·期（页码）：2019·47·第十二期（1466-1471）

摘要：

目的： 探讨剪切波速度（SWV）预测颈肩肌筋膜疼痛综合征（MPS）治疗后复发的价值。方法： 选择2017年12月至2018年10月我院收治的84例MPS患者作为研究对象。对患者随访1年，以是否发生终点事件为标准，将患者分为复发组与未复发组，比较两组患者视觉模拟评分（VAS）、疼痛评定指数（PRI）、现时疼痛强度（PPI）以及SWV的差异，分析上述指标对MPS复发的潜在预测价值。结果： MPS组的SWV与VAS（r=0.781，P=0.000）、PRI（r=0.753，P=0.000）和PPI均呈正相关（r=0.719，P=0.000）。治疗前后复发组患者VAS、PRI、PPI及SWV的变化量均低于未复发组（P<0.05）。多因素COX回归显示VAS（P=0.000）和SWV（P=0.000）是影响MPS患者预后的独立影响因素。VAS和SWV联合评估MPS预后的准确性最高（AUC=0.877），敏感性为87.50%，特异性为79.60%。结论： SWV值具有预测MPS患者预后的临床价值，VAS和SWV联合检测预测MPS预后的准确性最高。

Objective: To explore the value of shear wave velocity (SWV) in predicting the recurrence of neck and shoulder myofascial pain syndrome (MPS). Methods: Eighty-four patients with MPS admitted to our hospital from December 2017 to October 2018 were enrolled as subjects. The patients were followed up for 1 year. Patients were divided into recurrent and non-recurrent groups based on whether or not an endpoint occurred. The visual analogue scale (VAS), pain assessment index (PRI), current pain intensity (PPI), and SWV were compared between the two groups, and the potential predictive value of the above indicators was explored. Results: The SWV of MPS was positively correlated with VAS (r=0.781, P=0.000), PRI (r=0.753, P=0.000), and PPI (r=0.719, P=0.000). The changes of VAS, PRI, PPI and SWV of patients in the recurrent group were lower than those in the non-recurrent group before and after treatment (P<0.05). Multivariate COX regression showed that VAS (P=0.000) and SWV (P=0.000) were independent influencing factors influencing the prognosis of patients with MPS. The accuracy of combination of VAS and SWV in predicting the prognosis of MPS was the highest (AUC=0.877). The sensitivity was 87.50%, and the specificity was 79.60%. Conclusion: The SWV has clinical value in predicting prognosis in patients with MPS. The accuracy of combination of VAS and SWV inpredicting the prognosis of MPS is the highest.

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