肩关节撞击类固醇注射频率与糖尿病有关系吗

Naglaa A. Hussein, M. Bartels, Mark Thomas
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Full neurological exam. Main outcome measures: Number of steroid injections received and duration between each injection over past 2 years. Laboratory results: Glycosylated hemoglobin (HgA1c), liver and kidney functions. MRI shoulder results if available. Results: Mean age 59.4 ± 11.123. All patients were right-handed, Male 37.1%, female 62.9%, Mean body mass index (BMI) 32.2 ± 8.2. Majority were manual workers (55.1%). significant relationship between shoulder impingement and sex and BMI. HgA1c <5.5 has the fewest patients (7.3%), highest number of patients with HgA1c 5.5-6.0. significant incidence of shoulder impingement with rising category of HgA1c with highest among HgA1c >7 (p=0.0001) with significant bilateral disease. Significant incidence of shoulder impingement (unilateral or bilateral among diabetics (HgA1c>6) compared to non- diabetics (p=0.011). Mean number of injections among diabetics 1.1756 ± 1.17283, non-diabetics 0.6391 ± 0.89051 (p=0.0001). 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摘要

目的:探讨肩撞击患者类固醇注射频率、注射时间与糖尿病状态的关系。设计:回顾性。设置:门诊。参与者:在2019年1月1日至2020年12月期间,412名诊断为肩撞击综合征并接受类固醇注射治疗的单侧或双侧肩痛患者的图表。排除标准:有颈椎神经根病、神经肌肉疾病或肩部创伤史的患者。干预措施:审查和收集患者病历数据;人口统计资料,包括职业、身体质量指数、详细病史,包括糖尿病史。肩部检查,包括撞击刺激试验;霍金斯测试,诺氏征兆。颈部检查包括斯普林试验。全面的神经学检查。主要观察指标:过去2年内接受类固醇注射的次数和每次注射的持续时间。实验室结果:糖化血红蛋白(HgA1c)、肝肾功能。肩关节MRI结果(如有)。结果:平均年龄59.4±11.123岁。所有患者均为右撇子,男性37.1%,女性62.9%,平均体重指数(BMI) 32.2±8.2。体力劳动者居多(55.1%)。肩关节撞击与性别和BMI有显著关系。HgA1c为7 (p=0.0001),双侧病变显著。与非糖尿病患者相比,糖尿病患者(HgA1c>6)肩关节撞击(单侧或双侧)的发生率显著(p=0.011)。糖尿病患者平均注射次数为1.1756±1.17283次,非糖尿病患者平均注射次数为0.6391±0.89051次(p=0.0001)。DM与注射时间无显著相关性(p=0.129)。结论:类固醇注射治疗糖尿病性肩关节撞击有较好的疗效。没有研究讨论DM对类固醇注射频率的影响。本研究表明,肩关节撞击患者中糖尿病的存在显著增加了类固醇注射的频率,但不影响注射间隔时间。
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Is There Any Relationship between Frequency of Shoulder Impingement Steroid Injection and Diabetes Mellitus
Objective: Determine the relationship between frequency of steroid injections, duration between injections and diabetic status among shoulder impingement patients. Design: Retrospective. Setting: Outpatient. Participants: Charts of 412 patients presented with unilateral or bilateral shoulder pain diagnosed shoulder impingement syndrome and treated with steroid injections over a period of 01/2019-12/2020. Exclusion criteria: Those having manifestations suggesting of cervical radiculopathy, neuromuscular diseases, or shoulder trauma history. Interventions: Reviewing and collecting patient charts data; demographic data including occupation, body mass index, detailed medical history including DM history. Shoulder exam including impingement provocative tests; Hawkins test, Neer’s sign. Neck exam including Spurling test. Full neurological exam. Main outcome measures: Number of steroid injections received and duration between each injection over past 2 years. Laboratory results: Glycosylated hemoglobin (HgA1c), liver and kidney functions. MRI shoulder results if available. Results: Mean age 59.4 ± 11.123. All patients were right-handed, Male 37.1%, female 62.9%, Mean body mass index (BMI) 32.2 ± 8.2. Majority were manual workers (55.1%). significant relationship between shoulder impingement and sex and BMI. HgA1c <5.5 has the fewest patients (7.3%), highest number of patients with HgA1c 5.5-6.0. significant incidence of shoulder impingement with rising category of HgA1c with highest among HgA1c >7 (p=0.0001) with significant bilateral disease. Significant incidence of shoulder impingement (unilateral or bilateral among diabetics (HgA1c>6) compared to non- diabetics (p=0.011). Mean number of injections among diabetics 1.1756 ± 1.17283, non-diabetics 0.6391 ± 0.89051 (p=0.0001). No significant relation between DM and duration between injections (p=0.129). Conclusion: Steroid injection has proven efficacy in diabetic shoulder impingement patients. No studies discussed effect of DM on frequency of steroid injection. This study showed that presence of DM among shoulder impingement patients significantly increases the frequency of steroid injection but not affecting duration between injections.
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