网络出版日期: 2015-10-18
基金资助
北京市科技新星计划基金(2008A006)、北大清华生命科学联合中心和北京大学第三医院交叉人才培育计划(7252101)、北京大学医学部医信交叉建设项目(BMU20140424)资助
Effect of anterior cruciate ligament rupture on hamstring∶quadriceps ratio during isokinetic knee extension and flexion at 30 degrees of flexion
Online published: 2015-10-18
Supported by
Supported by the Beijing Nova Program (2008A006), the Scientific Research Starting Foundation for Returned Overseas Chinese Scholars, Peking University Third Hospital and PekingTsinghua Center for Life Sciences (7252101), the Seeding Grant for Medicine and Information Sciences of Peking University(BMU20140424)
目的：研究膝关节30°时前交叉韧带（anterior cruciate ligament，ACL）断裂对股四头肌（quadriceps，Q）和腘绳肌（hamstring，H）的肌力及其动态平衡的影响。方法：应用等速肌力测试系统（Con-Trex MJ）对25例男性单侧单纯ACL断裂患者在60°/s进行开链向心（concentric，c）和离心（eccentric，e）测试。选择膝关节30°时股四头肌或腘绳肌的等速向心和离心平均力矩，并计算其比值，包括股四头肌离心和向心比值（Qe∶Qc）、腘绳肌离心和向心比值（He∶Hc）、腘绳肌与股四头肌的向心比值（Hc∶Qc）、腘绳肌离心与股四头肌向心比值（He∶Qc）、腘绳肌向心与股四头肌离心比值（Hc∶Qe）。采用配对符号秩检验分析ACL断裂对上述参数的影响，结果以中位数（最小值~最大值）表示。结果：ACL断裂侧和未伤侧相比：（1）等速向心时，股四头肌平均力矩显著下降［61.2 (20.0~100.1) N·m vs. 84.0 (32.3~127.7) N·m，P<0.001］；（2）等速离心时，股四头肌平均力矩显著下降［55.3 (31.3~114.1) N·m vs. 71.7 (24.5~149.7) N·m，P=0.04］，腘绳肌平均力矩亦显著下降［55.3 (3.1~119.2) N·m vs. 80.3 (17.2~127.4) N·m，P=0.002］；（3）Hc∶Qc、He∶Qc和Qe∶Qc均显著增大（P<0.05）。结论：60°/s等速开链模式膝关节30°时H∶Q比值是评定ACL断裂患者大腿肌肉功能的新方法，ACL断裂侧的股四头肌力矩显著降低，Hc∶Qc、He∶Qc和Qe∶Qc显著增加。
黄红拾 , 蒋艳芳 , 杨洁 , 于媛媛 , 王懿 , 徐雁 , 敖英芳 . 膝关节30° 时前交叉韧带断裂对等速屈伸肌力比值的影响[J]. 北京大学学报（医学版）, 2015 , 47(5) : 787 -790 . DOI: 10.3969/j.issn.1671-167X.2015.05.010
Objective：To evaluate the change in hamstring (H):quadriceps (Q) ratio following anterior cruciate ligament (ACL) rupture during isokinetic knee extension and flexion at 30 degrees of flexion which is important for knee dynamic function. Methods: A study was performed in 25 male complete unilateral ACL ruptures. Isokinetic concentric and eccentric quadriceps and hamstring muscle tests in both the deficient knees and intact knees were performed at 60°/s, respectively. At 30 degrees of flexion, the average torque of quadriceps and hamstring, Qe∶Qc ratios (ratios of eccentric quadriceps to concentric quadriceps muscle torque), He∶Hc ratios (eccentric hamstring to concentric hamstring), Hc∶Qc ratios (concentric hamstring to concentric quadriceps), He∶Qc ratios (eccentric hamstring to concentric quadriceps), and Hc∶Qe ratios (concentric hamstring to eccentric quadriceps) were calculated. Wilcoxon matched-pairs signed-ranks test was used. Results: At 30 degrees of knee flexion, a significant reduction (P<0.05) in the average torque of quadriceps was observed at concentric and eccentric 60°/s produced by the deficient-side compared with the intact side. In addition, Hc∶Qc, He∶Qc, and Qe∶Qc significantly increased on the ACL-deficient side. Conclusion: The change in H ∶Q ratio in the mode of isokinetic 60°/s at 30 degrees of knee flexion might therefore be a new tool to objectively document muscle function in ACL-deficient knee.
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