体外冲击波疗法后肩部钙化性肌腱炎的临床、声像图和分子变化:一项前瞻性病例对照研究。

IF 12.5 2区 医学 Q1 SURGERY International journal of surgery Pub Date : 2024-09-06 DOI:10.1097/JS9.0000000000002078
Wen-Yi Chou, Kuan-Ting Wu, Po-Cheng Chen, Shun-Wun Jhan, Chia-Feng Wu, Jai-Hong Cheng
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引用次数: 0

摘要

背景:体外冲击波疗法(ESWT)是治疗肩部钙化性肌腱炎的主要方法,但体外冲击波疗法治疗肩部钙化性肌腱炎后,临床、声像图和分子标记物的效果如何?将 28 名患者分为放射密度亚组和放射透明亚组。此外,临床评估还包括视觉模拟量表(VAS)、Constant-Murley(CM)评分、美国肩肘外科医生(ASES)评分、声学评估和血清酶联免疫吸附试验(ELISA)。参与者完成了为期一年的随访。所有数据均在治疗前后收集:随访一年后,所有患者的 VAS、CM 和 ASES 评分均有明显改善,各亚组之间无明显临床差异。然而,放射线透视组在最后随访时显示出明显的完全吸收和体积缩小。声学评估显示,从3个月到12个月,所有患者的组织灌注都有所改善,钙化也有所减少,包括放射线透视组患者,但钙化沉积物并未完全吸收。ESWT 治疗后 1 个月和 3 个月,组织灌注的百分比有所改善。分子标记物白细胞介素-1β(IL-1 β)或IL-33的水平无明显差异,但胰岛素样生长因子1(IGF-1)的水平在ESWT后1个月和3个月明显增加。BMP7水平在3个月时有所上升,但在6个月和12个月时又显著下降:ESWT可改善症状,减少钙化,增强组织灌注,促进血管生成和BMP7活性。结论:ESWT 可改善症状,减少钙化,增强组织灌注,促进血管生成和 BMP7 活性。部分钙化吸收可改善透明度,建议在 3 个月后进行第二次 ESWT 治疗,以达到最佳效果。
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Clinical, sonographic and molecular changes in calcific tendinitis of the shoulder following extracorporeal shockwave therapy: a prospective case-control study.

Background: Extracorporeal shockwave therapy (ESWT) is the primary treatment for calcific tendinitis of the shoulders, but what are the effects of clinical, sonographic, and molecular markers following ESWT in treating calcific tendinitis of the shoulder?

Methods: Twenty-eight patients were categorized into radiodense and radiolucent subgroups. In addition, clinical assessments included the visual analogue scale (VAS), Constant-Murley (CM) score, American Shoulder and Elbow Surgeon (ASES) score, sonographic evaluation, and serum enzyme-linked immunosorbent assay (ELISA). The participants completed a one-year follow-up. All data were collected before and after treatment.

Results: After one year of follow-up, all patients showed notable improvement in VAS, CM, and ASES scores, with no significant clinical variations among the subgroups. However, the radiolucent group showed significant complete resorption and size reduction at the final follow-up. Sonographic evaluation revealed improved tissue perfusion and reduced calcification from 3 to 12 months in all patients, including those in the radiolucent group, but complete resorption of calcific deposits did not occur. The percentage of tissue perfusion was improved at 1 and 3 months after ESWT. There were no significant differences in the levels of the molecular markers interleukin-1 beta (IL-1 β) or IL-33, but the level of insulin-like growth factor 1 (IGF-1) was notably increased at 1 and 3 months post-ESWT. The BMP7 level was increased at 3 months and was then decreased significantly at 6 and 12 months.

Conclusion: ESWT improved symptoms, reduced calcification, enhanced tissue perfusion, and promoted angiogenesis and BMP7 activity. In particular, it benefited radiolucent type patients with better calcification resorption. Partial resorption led to improvements in transparency, and a second ESWT session at 3 months was recommended for optimal results.

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来源期刊
CiteScore
17.70
自引率
3.30%
发文量
0
审稿时长
6-12 weeks
期刊介绍: The International Journal of Surgery (IJS) has a broad scope, encompassing all surgical specialties. Its primary objective is to facilitate the exchange of crucial ideas and lines of thought between and across these specialties.By doing so, the journal aims to counter the growing trend of increasing sub-specialization, which can result in "tunnel-vision" and the isolation of significant surgical advancements within specific specialties.
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