摘要
目的:探讨痉挛型脑性瘫痪(脑瘫)患儿小腿三头肌肌肉形态、结构变化并探讨其与年龄、运动功能的相关性.方法:选取2～8 岁痉挛型脑瘫36 例(男18 例,女18 例),根据年龄、性别匹配20 名正常儿童作为对照.超声成像下评估两组小腿三头肌羽状角、肌束长度、肌肉厚度、横截面积、肌腹长度、跟腱长度.使用 88 项粗大运动功能评定量表(GMFM-88)的D能区和E能区、改良Ashworth量表(MAS)评估脑瘫患儿的粗大运动功能和小腿肌肉痉挛程度.结果:痉挛型脑瘫患儿内、外侧腓肠肌肌肉厚度和横截面积,内、外侧腓肠肌和比目鱼肌肌束长度、内侧腓肠肌标准化肌腹长度小于对照组(P<0.05);内侧腓肠肌羽状角、标准化跟腱长度大于对照组(P<0.05);两组内侧腓肠肌肌肉厚度、横截面积、肌束长度均与年龄呈正相关(P<0.05).脑瘫患儿内侧腓肠肌肌肉厚度及横截面积、外侧腓肠肌肌束长度、比目鱼肌肌肉厚度与GMFM总分呈正相关(rP 分别为0.639、0.392、0.399、0.338,P<0.05),各肌肉形态参数与踝关节MAS评分不相关(P>0.05).结论:痉挛型脑瘫患儿肌肉发育受限,且与运动功能水平密切相关,随着年龄增长,肌肉发育受限更为显著.
Abstract
Aim:To explore the morphological and structural changes of triceps surae of spastic cerebral palsy(CP)children and their correlation with age and motor function.Methods:A total of 36 cases of spastic CP aged 2-8 years were selected,18 females and 18 males;20 normal children matched according to age and gender were the control.The muscle morphology and structure were assessed by ultrasound imaging,including pinnation angle,muscle fascicle length,muscle thickness,cross-sectional area,muscle belly length and achilles tendon length of triceps surae.D-energy region and E-energy region of 88 Gross Motor Function Measurement Scale(GMFM-88)and the modified Ashworth Scale(MAS)were used to e-valuate gross motor function and calf muscle spasm of CP children.Results:Compared with those of control group,the mus-cle thickness and cross-sectional area of gastrocnemius,muscle fascicle length of gastrocnemius and soleus,and the stand-ardized muscle belly length of medial gastrocnemius in CP group were less,and the pinnation angle of medial gastrocnemius and standardized achilles tendon length were more(P<0.05).The muscle thickness,cross-sectional area and muscle fasci-cle length of medial gastrocnemius in both groups were positively correlated with age(P<0.05).Thickness and cross-sec-tional area of medial gastrocnemius,the muscle fascicle length of lateral gastrocnemius and the thickness of soleus of CP children were positively correlated with GMFM scores,r(P)was 0.639,0.392,0.399,0.338,respectively(P<0.05),while there was no significant correlation between each muscle morphological parameter and MAS score of ankle(P>0.05).Conclusion:Children with spastic CP have limited muscle development,which is closely related to the level of motor func-tion.The limitation of muscle development is more obvious with age.
基金项目
河南省重点研发与推广专项(232102310135)
国家科技期刊平台
NSTL
万方数据