目的:探索脑卒中后偏瘫肩痛(hemiplegic shoulder pain,HSP)超声异常表现及其与疼痛视觉模拟量表(visual analogue scale,VAS)评分的相关性,为肌骨超声对肩周疾病的量化评估提供新的方法.方法:选取62例偏瘫患者,根据VAS量表评分,分为肩痛组(37例)与非肩痛组(25例).所有患者均进行Brnnstrom、改良Ashworth、VAS评定及双肩肌骨超声检查,对肩痛组的超声异常表现与VAS进行相关性分析.结果:肩痛组肱二头肌长头肌腱(biceps longhead tendon,BICT)、冈上肌(supraspinatus tendons,SST)病变、肩峰-三角肌下滑囊(subacromial-subdeltoid bursa, SA-SD)发生率高于非肩痛组,差异有统计学意义[51.3％(19/37) vs 28.0％(7/25),56.8％(21/37) vs 24.0％(6/25), 40.5％(15/37) vs 16.0％(4/25); P＜0.05)].肩痛组盂肱关节下方关节囊厚度(inferior capsule thickness, ICT)、肩峰至大结节间距结果均大于非肩痛组,差异有统计学意义[(3.69±1.03) mm vs (3.14±0.91) mm,(30.59±2.58) mm vs (26.98±2.84) mm; P＜0.05)].肩痛组超声异常表现与VAS相关性分析显示BICT病变、SST病变、SA-SD、盂肱关节ICT、肩峰至大结节间距与VAS均呈正相关,差异有统计学意义(r=0.54,r=0.60,r=0.38,r=0.55,r=0.61; P＜0.05).结论:超声异常与肩痛程度之间存在相关性,肌骨超声可作为量化评估肩周软组织病变的新方法.%Objective: To explore the correlation between the ultrasonic manifestations of shoulder soft tissue lesions and visual analogue scale (VAS) in patients with hemiplegic shoulder pain (HSP),and to provide a new method for quantitative assessment of the shoulder lesion. Methods: A total of 62 patients with hemiplegia were enrolled, according to the VAS scale score, they were divided into shoulder pain group (37 cases) and non-shoulder pain group (25 cases). All of them were evaluated by Brunnstrom, modified Ashworth, VAS. All shoulders were examined by musculoskeletal ultrasound, and analyzed the correlation between ultrasound abnormalities and VAS in shoulder pain group. Results: In the shoulder pain group, the incidence of the long head of biceps tendon, supraspinatus lesion and subacromial-subdeltoid bursa effusion in the shoulder pain group was higher than that in the non-shoulder pain group [51.3％ (19/37) vs 28％ (7/25),56.8％ (21/37) vs 24％ (6/25),40.5％ (15/37) vs 16.0％(4/25); P＜0.05)], and the difference was statistically significant. The thickness of the inferior capsule and the distance from the acromion to the greater tubercle were greater than that of the non-shoulder pain[(3.69±1.03) mm vs(3.14±0.91) mm,(30.59±2.58) mm vs(26.98±2.84) mm; P＜0.05)], and the difference was statistically significant. The correlation between abnormal sonographic findings and VAS correlation showed that the long head of biceps tendon lesion, the supraspinatus, and sub deltoid-subacromial bursa effusion, the thickness of the joint capsule, the distance from the acromion to the greater tubercle were all positively correlated with VAS in the shoulder pain group(r=0.54, r=0.60, r=0.38, r=0.55, r=0.61; P＜0.05), and the difference was statistically significant. Conclusion: There is a correlation between ultrasound abnormalities and shoulder pain. Musculoskeletal ultrasound can be used as a new method for quantitative assessment of soft tissue lesions of the shoulder.
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