完全性脊髓损伤前6个月对骨骼肌横截面积的影响。

M J Castro, D F Apple, E A Hillegass, G A Dudley
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引用次数: 353

摘要

在这项研究中,我们研究了完全性脊髓损伤(SCI)对损伤后6个月内骨骼肌形态的影响。在患者临床稳定后、损伤后平均6周、脊髓损伤后11周和24周,立即对腿部和大腿进行磁共振(MR)成像,以评估平均肌肉横截面积(CSA)。在相隔18周的两个时间点,对9名健全的对照组进行了核磁共振成像。对照组显示,随着时间的推移,任何变量都没有变化。患者表现为踝关节足底或背屈肌的差异萎缩(P = 0.0001)。腓肠肌和比目鱼肌的平均CSA分别下降24%和12% (P = 0.0001)。胫骨前肌CSA无明显变化(P = 0.3644)。由于这种肌肉特异性萎缩,腓肠肌与比目鱼肌、腓肠肌与胫前肌、比目鱼肌与胫前肌的平均CSA比值下降(P = 0.0001)。m、股四头肌、腘绳肌群和内收肌群的平均CSA分别下降16%、14%和16% (P< or =0.0045)。各组大腿肌群间无差异萎缩,csa比值无变化(P = 0.6210)。损伤后24周,患者萎缩骨骼肌的平均CSA为年龄和体重匹配的健全对照组的45-80%。综上所述,本研究的结果表明,脊髓损伤后早期存在明显的收缩蛋白损失,这在受影响的骨骼肌中是不同的。虽然导致肌肉大小减少的机制尚不清楚,但这表明肌肉失衡的发展以及肌肉质量的减少会在脊髓损伤后早期损害力潜能。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Influence of complete spinal cord injury on skeletal muscle cross-sectional area within the first 6 months of injury.

In this study we examined the influence of complete spinal cord injury (SCI) on affected skeletal muscle morphology within 6 months of SCI. Magnetic resonance (MR) images of the leg and thigh were taken as soon as patients were clinically stable, on average 6 weeks post injury, and 11 and 24 weeks after SCI to assess average muscle cross-sectional area (CSA). MR images were also taken from nine able-bodied controls at two time points separated from one another by 18 weeks. The controls showed no change in any variable over time. The patients showed differential atrophy (P = 0.0001) of the ankle plantar or dorsi flexor muscles. The average CSA of m. gastrocnemius and m. soleus decreased by 24% and 12%, respectively (P = 0.0001). The m. tibialis anterior CSA showed no change (P = 0.3644). As a result of this muscle-specific atrophy, the ratio of average CSA of m. gastrocnemius to m. soleus, m. gastrocnemius to m. tibialis anterior and m. soleus to m. tibialis anterior declined (P = 0.0001). The average CSA of m, quadriceps femoris, the hamstring muscle group and the adductor muscle group decreased by 16%, 14% and 16%, respectively (P< or =0.0045). No differential atrophy was observed among these thigh muscle groups, thus the ratio of their CSAs did not change (P = 0.6210). The average CSA of atrophied skeletal muscle in the patients was 45-80% of that of age- and weight-matched able-bodied controls 24 weeks after injury. In conclusion, the results of this study suggest that there is marked loss of contractile protein early after SCI which differs among affected skeletal muscles. While the mechanism(s) responsible for loss of muscle size are not clear, it is suggested that the development of muscular imbalance as well as diminution of muscle mass would compromise force potential early after SCI.

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