骨关节病患者肌纤维萎缩类型及其与日常活动的相关性

背景：骨关节病患者因制动等原因可出现严重的肌纤维萎缩,但目前对这类肌纤维萎缩的微观分类及其与日常活动的研究较少。 目的：观察骨关节病患者肌肉萎缩类型以及其与日常活动的相关性。 方法：纳入24例老年女性骨关节病患者,应用功能独立性评定量表对患者习惯性的日常运动进行了评价,在进行关节置换过程中对患者肌纤维进行了测定并通过活检进行组织病理学侧量。同时选取同期因骨折需要进行修复的4例女性患者为对照组。观察患者的肌纤维(Ⅰ型、ⅡA型和ⅡB型)发生萎缩类型和比率变化。 结果与结论：骨关节病患者根据发生萎缩的肌纤维类型不同,分为1型、2B型何1+2AB型。Ⅰ型的肌纤维肌横截面积明显小于ⅡA型和ⅡB型肌纤维(P < 0.05)。大部分骨关节病患者在得病过程中仅发生同一种肌纤维类型的萎缩,而非所有的肌纤维均出现萎缩。功能独立性评定量表评分从1+2AB型,2B型和1型逐渐减少(P < 0.05)。结果证实,肌肉萎缩1+2AB型对骨关节病患者日常活动影响最大,而单纯的2B型影响最小。

Different muscle fiber type atrophy in osteoarthritis patients and its relationship with activities of daily living

BACKGROUND:Severe muscle fiber atrophy can occur in osteoarthritis patients. However, there are few studies about the classification of muscle fiber atrophy and activities of daily living. OBJECTIVE:To observe the type of muscle fiber atrophy and its relationship with activities of daily living. METHODS: Totally 24 female osteoarthritis patients, aged (52.4±16.0) years, were selected, who underwent a vastus lateralis muscle biopsy at the time of total hip or knee replacement. At the time of referral to the rehabilitation center, the Functional Independence Measure (FIM) motor score and habitual physical activity at home were evaluated, and the diameter and atrophy factor for each muscle fiber type were measured on the histopathology preparations of the biopsied muscles. RESULTS AND CONCLUSION:The patients showed muscle fiber atrophy and small angular fibers, and the atrophy factor was significantly increased in type 1, 2A, and 2B fibers, in that order (P < 0.05). The patterns of the fiber type atrophy, consisting of normal, type 2B atrophy, and type 1 and 2AB atrophy, had a significant relationship with the fiber type atrophy (P  < 0.001). The FIM motor score showed a significant correlation among the three patterns of the fiber type atrophy (P  < 0.05). Type 1+2AB has a best effect on activities of daily living in osteoarthritis patients, and type 2B has a minimal effect.