剪切波弹性成像技术对脑卒中偏瘫患者肌张力和肌肉硬度的评估价值研究

摘要 目的：研究应用剪切波弹性成像技术对脑卒中偏瘫患者肌张力、肌硬度进行评估的临床价值。方法：选取2019年3月到2021年2月在我院进行治疗的79例脑卒中偏瘫患者作为研究对象，应用超声仪检测所有研究对象健康侧（健侧）和患病侧（患侧）肱二头肌、肱肌和肱桡肌放松位和拉伸位下杨氏模量值，进行对比分析。结果：在放松位下，脑卒中偏瘫患者患侧肱二头肌和肱桡肌杨氏模量与健康侧肌肉相比无显著差异（P>0.05），而患侧肱肌杨氏模量显著低于健侧（P<0.05）。在拉伸位下，脑卒中偏瘫患者患侧肱二头肌、肱肌和肱桡肌杨氏模量均显著高于健康侧肌肉（P<0.05）；脑卒中偏瘫患者放松位与拉伸位肱二头肌、肱肌和肱桡肌杨氏模量差值也均显著高于健康侧肌肉（P<0.05）。此外，不同改良Ashworth肌张力分级的脑卒中偏瘫患者患侧肱二头肌、肱肌和肱桡肌杨氏模量均存在显著差异（P<0.05），并且患侧肱二头肌、肱肌和肱桡肌杨氏模量值随改良Ashworth肌张力分级升高而增加。结论：剪切波弹性成像技术可用于评估脑卒中偏瘫患者肌张力、肌硬度，以指导临床康复。

Evaluation Value of Shear Wave Elastography in the Evaluation of Muscle Tension and Muscle Stiffness in Stroke Patients with Hemiplegia

ABSTRACT Objective: To study the clinical value of applying shear wave elastography technology to assess muscle tension and muscle stiffness in stroke patients with hemiplegia. Methods: Seventy-nine stroke patients with hemiplegia who were treated in our hospital from March 2019 to February 2021 were selected as the research objects, and the healthy side (unhealthy side) and the diseased side (affected side) of the two heads of the brachial head of all the subjects were detected by ultrasound. The Young''s modulus values of the muscles, brachialis and brachioradialis in the relaxed and stretched positions were compared and analyzed. Results: In the relaxed position, the Young''s modulus of the biceps and brachioradialis on the affected side of stroke patients was not significantly different from that of the healthy side (P>0.05), while the Young''s modulus of the affected side of the brachial muscle was significantly lower than that of the healthy side. The healthy side (P<0.05). In the stretching position, the Young''s modulus of the biceps, brachialis and brachioradialis on the affected side of stroke patients with hemiplegia was significantly higher than that of the healthy side muscles (P<0.05); and the difference in Young''s modulus of the biceps, brachialis and brachioradialis in the relaxed and stretched positions of stroke patients with hemiplegia was also significantly higher than that of the healthy side muscles (P<0.05). In addition, there were significant differences in Young''s modulus of biceps, brachii and brachioradialis in stroke hemiplegia patients with different modified Ashworth muscle tension classifications (P<0.05), and the Young''s modulus of the affected brachialis and brachioradialis muscles were significantly different. The modulus value increased with the increase of modified Ashworth muscle tone. Conclusion: Shear wave elastography technology can be used to evaluate the muscle tension and muscle stiffness of stroke patients with hemiplegia to guide clinical rehabilitation.