RELATIONSHIP BETWEEN WEAKNESS AND MUSCLE WASTING IN RHEUMATOID-ARTHRITIS
RELATIONSHIP BETWEEN WEAKNESS AND MUSCLE WASTING IN RHEUMATOID-ARTHRITIS
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DOI：
10.1136/ard.53.11.726
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发表时间：
1994-11-01
影响因子：
27.4
通讯作者：
JACKSON, S
中科院分区：
文献类型：
--
作者：
HELLIWELL, PS;JACKSON, S
目的：探讨类风湿关节炎（RA）患者的握力无力与前臂肌肉量减少、手部关节畸形和手部关节压痛之间的关系。方法：利用人体测量数据，我们估计了100名RA患者前臂肌肉的解剖截面积（CSA），并与100名年龄和性别匹配的正常受试者进行了比较。我们还使用Ritchie关节指数和简单的手部关节畸形指数来记录手部关节压痛。结果：我们发现RA的解剖CSA显著降低(正常受试者前臂CSA为29.7 cm(2)， RA为25.9 cm(2)；P = 0.002)。在简单线性回归中，我们发现正常受试者握力变化的46.3%可以用肌肉CSA的变化来解释；在RA，这一数字下降到33.4%。在多元回归模型中加入关节畸形和疼痛的术语将解释的变异量提高到37.9%。结论：尽管类风湿关节炎中存在明显的肌肉萎缩，但力量的减少很可能也可归因于关节畸形和疼痛，从而直接或间接地通过关节源性肌肉抑制抑制握力。对于类风湿性关节炎的肌肉质量仍然存在疑问。
Objective-To relate weakness of grip to loss of forearm muscle bulk, hand joint deformity, and hand joint tenderness in patients with rheumatoid arthritis (RA).Methods-Using anthropometric data we have estimated the anatomical cross-sectional area (CSA) of forearm muscles in 100 subjects with RA compared with 100 aged and sex-matched normal subjects. We also recorded hand joint tenderness using a modification of the Ritchie articular index, and a simple index of hand joint deformity.Results-We found a significant reduction in anatomical CSA in RA (forearm CSA in normal subjects 29.7 cm(2) and in RA 25.9 cm(2); p = 0.002). In simple linear regression we found that 46.3% of the variation in grip strength in normal subjects was explained by variation in muscle CSA; in RA this figure decreased to 33.4%. Adding terms for joint deformity and pain in a multiple regression model improved the amount of variation explained to 37.9%.Conclusions-Although there is significant muscle wasting in RA, it is likely that reduction in strength is also attributable to joint deformity and pain leading to inhibition of grip directly and, indirectly, by arthrogenous muscle inhibition. Doubts remain about the quality of muscle in RA.