摘要
目的:探讨粘连性肩关节炎盂肱关节下关节囊(IC)厚度、血清白细胞介素-1β(IL-1β)、环氧酶2(COX-2)水平,并分析其与病情程度相关性及其对粘连性肩关节炎的诊断价值。方法:选取2022年7月至2024年7月粘连性肩关节炎患者210例作为研究组,另选取同期健康志愿者105例作为对照组。比较两组IC厚度、血清IL-1β、COX-2水平。采用Constant-Murley肩关节功能(CMS)评分、视觉模拟评分(VAS)评分作为评估病情程度依据,分别分为4个亚组,比较其IC厚度、血清IL-1β、COX-2水平。分析IC厚度、血清IL-1β、COX-2水平对粘连性肩关节炎的诊断价值。相关性分析IC厚度、血清IL-1β、COX-2水平与CMS评分、VAS评分的相关性。结果:研究组患侧IC厚度大于对照组左侧IC厚度(3.35±0.94mm vs 1.26±0.27mm,t=22.312、P<0.001)、对照组右侧IC厚度(3.35±0.94mm vs 1.20±0.24mm,t=23.048、P<0.001);研究组两侧IC厚度差大于对照组两侧IC厚度差(2.14±0.63mm vs 0.06±0.02mm,t=33.796、P<0.001);研究组血清IL-1β、COX-2水平分别为(28.15±9.85)ng/mL、(23.69±7.28)pg/mL,高于对照组的(13.64±4.17)ng/mL、(12.41±4.05)pg/mL(P<0.05);患侧IC厚度、血清IL-1β、COX-2水平在C1亚组、C2亚组、C3亚组、C4亚组呈逐渐下降趋势,患侧IC厚度、血清IL-1β、COX-2水平在V1亚组、V2亚组、V3亚组、V4亚组呈逐渐升高趋势(P<0.05);患侧IC厚度、血清IL-1β、COX-2水平单项及联合诊断粘连性肩关节炎的AUC为0.776、0.770、0.753、0.923,敏感度为80.48%、69.52%、64.29%、80.00%,特异度为61.90%、74.29%、74.29%、91.43%,且联合诊断价值显著高于各指标单独诊断价值(Z=4.896、4.871、5.439,P均<0.001);列联相关性分析显示,患侧IC厚度、血清IL-1β、COX-2水平与CMS评分呈负相关,与VAS评分呈正相关(P<0.05)。结论:粘连性肩关节炎患者IC厚度增加,血清IL-1β、COX-2水平升高,且与病情程度密切相关,联合检测其水平对粘连性肩关节炎具有一定诊断价值,联合检测可提高诊断效能。
Objective:To investigate the thickness of the inferior capsule(IC)of the glenohumeral joint in adhesive shoulder arthritis,the levels of serum interleukin-1β(IL-1β)and cyclooxygenase-2(COX-2),and analyze their correlation with disease severity and diagnostic value for adhesive shoulder arthritis.Methods:A total of 210 patients with adhesive shoulder arthritis from July 2022 to July 2024 were selected as the study group,and 105 healthy volunteers during the same period were selected as the control group.The IC thickness,serum IL-1β,and COX-2 levels were compared between the two groups.The Constant-Murley Shoulder Function(CMS)score and Visual Analogue Scale(VAS)score were used as the basis for evaluating the severity of the disease,and were divided into four subgroups.IC thickness,serum IL-1β,and COX-2 levels were compared.The diagnostic value of IC thickness,serum IL-1β,and COX-2 levels was analyzed for adhesive shoulder arthritis.Correlation analysis was used to analyze the correlation between IC thickness,serum IL-1β,COX-2 levels,and CMS scores and VAS scores.Results:The thickness of the IC on the affected side of the study group was greater than that on the left side of the control group(3.35±0.94mm vs 1.26±0.27mm,t=22.312,P<0.001),and on the right side of the control group(3.35±0.94mm vs 1.20±0.24mm,t=23.048,P<0.001);the thickness difference between the two sides of the IC in the research group was greater than that in the control group(2.14±0.63 mm vs 0.06±0.02 mm,t=33.796,P<0.001);the levels of serum IL-1βand COX-2 in the study group were(28.15±9.85)ng/mL and(23.69±7.28)pg/mL,respectively,which were higher than those in the control group at(13.64±4.17)ng/mL and(12.41±4.05)pg/mL(P<0.05).The thickness of the affected side of the IC,serum levels of IL-1β,and COX-2 showed a gradual downward trend in C1,C2,C3,and C4 subgroups,while the thickness of the affected side of the IC,serum levels of IL-1β,and COX-2 showed a gradual upward trend in V1,V2,V3,and V4 subgroups(P<0.05).The AUC of IC thickness,serum IL-1β,COX-2 levels,and their combined diagnosis for adhesive shoulder arthritis on the affected side were 0.776,0.770,0.753,and 0.923,with sensitivities of 80.48%,69.52%,64.29%,and 80.00%,and specificities of 61.90%,74.29%,74.29%,and 91.43%.The combined diagnostic value was significantly higher than that of each individual indicator(Z=4.896,4.871,5.439,all P<0.001).The contingency correlation analysis showed that the thickness of the affected side of the IC,serum IL-1β,and COX-2 levels were negatively correlated with CMS scores and positively correlated with VAS scores(P<0.05).Conclusion:The thickness of IC in patients with adhesive shoulder arthritis increases,and the levels of serum IL-1βand COX-2 increase,which are closely related to the severity of the disease.Combined detection of their levels has certain diagnostic value for adhesive shoulder arthritis,and combined detection can improve diagnostic efficiency.
作者
梁婷婷
李崇珍
马丽
宋婷婷
LIANG Tingting(Yunnan Provincial Hospital of Traditional Chinese Medicine,Yunnan Kunming 650021,China)
出处
《河北医学》
2025年第8期1369-1375,共7页
Hebei Medicine
基金
云南省卫生健康委临床医学中心2022年至2024年建设项目,(编号:202201AF190112)。
关键词
粘连性肩关节炎
盂肱关节
关节囊厚度
白细胞介素-1Β
环氧酶2
诊断价值
Adhesive shoulder arthritis
Glenohumeral joint
Thickness of the inferior capsule
Interleukin-1β
Cyclooxygenase 2
Diagnostic value
