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非侵入式軟骨退化評估系統於足球運動員之驗證

Development a non-invasive assessing system of cartilage degeneration for football players

摘要


緒論:在運動損傷中,以軟組織、膝關節、踝關節和腿的比例最高,建立準確度高、可信度高且快速便利之軟骨退化評估系統,有助於早期發現運動員軟骨退化情形,並施以治療行為,以延長其運動生涯及減少日後醫療資源之支出。方法:本研究使用臨床上之國際膝部(IKDC)問卷式評估表衡量軟骨退化情形(IKDC分數全距:0-100;總分愈高,退化可能性愈低),以及使用「非侵入式免疫層析尿液試片」對尿液檢測軟骨退化標誌物(軟骨寡聚基質蛋白[cartilage oligomeric matrix protein, COMP]),以其存在與否,作為運動員軟骨退化的評估檢測。結果:本研究發現在60位非運動員中,X光片診斷46位為無關節軟骨退化、14位有關節軟骨退化症狀。無退化症狀組之IKDC平均分數(88.45 ± 11.68分)顯著高於有退化症狀組(49.09 ± 21.82分);尿液試片檢驗診斷關節退化的偵測命中率為85.7%、整體正確率為92.9%。在59位足球運動員中,X光片診斷33位無退化症狀、26位有退化症狀,無退化症狀組之IKDC平均分數(81.70 ± 15.79分)顯著高於有退化症狀組(57.43 ± 15.84分);尿液試片在關節退化的偵測命中率為96.2%、整體正確率為89.0%。結論:藉由「非侵入式免疫層析尿液試片」檢測尿液檢體以評估軟骨退化情形,此種檢驗方式具有高度敏感度及良好正確率,和X光之檢驗結果亦具有高度相關性(非運動員:φ=.906、足球運動員:φ=.613),顯示這項創新的軟骨退化標誌檢測技術,結合臨床上普遍採用的主觀性IKDC評估表,將更具使用便利性、診斷正確性及預防效用性。

並列摘要


Introduction: Soft tissues, knee joint, ankle joint and leg injuries are the most encountered sport injuries. Thus, developing a high accuracy, highly reliable and rapid / easy detection method or tool for diagnosing articular cartilage degeneration at early stage is crucial to prolong football player's careers and to reduce the waste of coaching and related medical resources. Methods: This study is the first trial to adopt a clinically proven "IKDC Score" subjective knee evaluation questionnaire (score range 0-100, healthy cartilage with higher scores) combined with a non-invasive immunochromatographic strip for urine specimens to objectively detect the presence of the marker of articular cartilage degeneration (cartilage oligomeric matrix protein, COMP) from degenerated cartilage and thus to evaluate the health condition of joint cartilage of football players. Results: Among 60 non-football players (from the X-ray diagnoses: 46 of them being healthy, whereas 14 found being with symptoms of degenerated cartilage), these healthy subjects scored an average IKDC of 88.45 ± 11.68, yet those with degenerated cartilage scored 49.09 ± 21.82 (with significant difference). The non-invasive immunochromatographic urine test strip analysis demonstrated that the strip sensitivity is 85.7% and the accuracy is 92.9% from 60 non-football players' samples. As for the 59 football players (clinically, there were 33 players being healthy and 26 with degenerated cartilage), healthy football players scored an average IKDC of 81.7 ± 15.79, whereas those with degenerated cartilage scored a significantly lower 57.43 ± 15.84. The sensitivity of the immunochromatographic urine test strip is around 96.2% and the accuracy 89% from these samples. Conclusion: The preliminary results revealed that the non-invasive immunochromatographic urine test strip has high sensitivity and accuracy that able to detect the degeneration of cartilage from these subjects. Importantly, there existed a high co-relationship between this non-invasive immunochromatographic strip tests results and the clinical X-ray examinations (non-football players: φ = .906, football players: φ = .613). The obtained results indicate that a combined urine test strip and subjective IKDC knee evaluation questionnaire could be employed for quick screening of the condition of the articular cartilage with easy manipulation, correct diagnosis and preventive effect benefits in football players.

參考文獻


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