摘要目的 初步研究无症状高尿酸血症对关节镜下肩袖修补术后患者肩关节功能恢复及肌腱愈合的影响。 方法 回顾性分析新疆维吾尔自治区人民医院骨科中心2021年11月至2023年1月收治的55例肩袖撕裂患者的临床资料。根据血尿酸水平分为高尿酸血症组26例和血尿酸正常组29例(诊断高尿酸血症标准为非同日两次血尿酸>420 μmol/L)。高尿酸血症组男17例，女9例；年龄38～69岁，平均(53.4±8.8)岁；血尿酸正常组男16例，女13例；年龄44～74岁，平均(53.9±11.3)岁。记录术前、术后3个月、术后6个月的肩关节前屈活动度、外旋活动度、内旋活动度、疼痛视觉模拟评分(visual analogue scale，VAS)、Constant-Murley肩关节评分、美国肩肘外科医师协会评分(American shoulder and elbow surgeons，ASES)评估肩关节功能。末次随访时完善肩关节X线片和MRI检查，参照Sugaya评价标准评价肩袖愈合情况。 结果 55例患者术后均获随访，随访时间6～8个月，其中高尿酸血症组和血尿酸正常组随访时间分别为(6.56±0.64)个月和(6.62±0.62)个月，两组随访时间差异无统计学意义( t ＝－0.256， P ＝ 0.771 )。两组患者术后各项观察指标均较术前明显改善( P ＜0.05)。术后3个月、6个月的随访结果显示，血尿酸正常组患者术后肩关节前屈活动度、外旋活动度、内旋活动度、VAS、Constant-Murley肩关节评分、ASES评分均优于高尿酸血症组患者，差异有统计学意义( P ＜0.05)。末次随访时43例患者完善肩关节MRI检查。根据Sugaya标准评价结果显示，血尿酸正常患者MRI分级优于高尿酸血症组，两组间差异有统计学意义( Z ＝－1.985， P ＝0.047)。 结论 关节镜下肩袖修补术后患者中，血尿酸正常患者肩关节功能、疼痛程度及肌腱愈合效果优于高血尿酸患者。
Abstract：Objective To preliminarily study the effect of asymptomatic hyperuricemia on functional recovery of the shoulder joint and tendon healing in patients after arthroscopic rotator cuff repair. Methods We retrospectively analyzed the clinical data of 55 patients with rotator cuff tears admitted to the Orthopedic Center of Xinjiang Uygur People’s Hospital between November 2021 and January 2023.The study participants were divided into two groups based on their blood uric acid levels：The hyperuricemia group (26 cases) and the normal blood uric acid group (29 cases).Hyperuricemia was diagnosed when the uric acid level was greater than 420 μmol/L on two separate occasions (not on the same day).The hyperuricemia group consisted of 17 males and 9 females，with ages ranging from 38 to 69 years old and an average age of (53.4±8.8) years old.The normal blood uric acid group consisted of 16 males and 13 females，with ages ranging from 44 to 74 years old and an average age of (53.9±11.3) years old.Shoulder flexion mobility，external rotation mobility，internal rotation mobility，visual analogue scale (VAS)，Constant-Murley shoulder score，American shoulder and elbow surgeon(ASES) were recorded at 3 months and 6 months after surgery.At the final follow-up，shoulder radiographs and MRI were conducted to evaluate the healing of the rotator cuff using the Sugaya evaluation criteria. Results 55 patients were followed up postoperatively，ranging from 6 to 8 months，the follow-up times in the hyperuricemic and normal groups were (6.56±0.64) months and (6.62±0.62) months，respectively，and the difference in the follow-up times between the two groups did not reach statistical significance ( t ＝－0.256， P ＝ 0.771 ).The postoperative observational indexes of patients in both groups were significantly improved compared with the preoperative period ( P ＜0.05).The follow-up results at 3 and 6 months after surgery showed that the postoperative shoulder forward flexion mobility，external rotation mobility，internal rotation mobility，VAS score，Constant-Murley shoulder score，and ASES score of patients in the normal blood uric acid group were better than those of patients in the hyperuricemia group，and the difference was statistically significant ( P ＜0.05).Shoulder MRI was performed in 43 patients at the last follow-up.According to the Sugaya criteria，the evaluation results showed that MRI grading was better in patients with normal blood uric acid than in the hyperuricemia group，and the difference between the two groups was statistically significant ( Z ＝－1.985， P ＝0.047). Conclusion Among the patients after arthroscopic rotator cuff repair，the shoulder joint function，pain level and tendon healing results of patients with normal blood uric acid are better than those of patients with hyperuricemia.
图达吉·吾布力哈斯木，张浩沙强，王志刚，李坤. 无症状高尿酸血症对肩袖修补术后疗效影响的分析[J]. 实用骨科杂志, 2024, 30(2): 120-.
Tudaji·Wubulihasimu，Zhang Haoshaqiang，Wang Zhigang，Li Kun. Analysis of the Impact of Asymptomatic Hyperuricemia on Patient Outcomes After Rotator Cuff Repair. sygkzz, 2024, 30(2): 120-.
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