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Chinese Medical Journal 2002年第6期 142-143页

作者：张耀南 Hashimoto Jun inui hiroaki Nobuhara Katsuya

ZHANG Yaonan , Hashimoto Jun, inui hiroaki and Nobuhara Katsuya Department of Orthopaedics, Beijing Hospital, Beijing 100730, China (Zhang YN)

关键词： impingement symptom · footballer’s ankle · degenerative joint disease

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肩袖撕裂与肩峰骨棘之间关系的临床研究

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中华关节外科杂志（电子版） 2010年第1期4卷 3-7页

作者：张耀南乾皓明驹井正彦桥本淳金谷整亮信原克哉卫生部北京医院骨科 100730 信原病院暨生物力学研究所整形外科

目的回顾性分析肩袖撕裂患者术前肩关节X线片显示的肩峰骨棘的形态学变化,探讨与其合并肩袖撕裂的关系。方法依据1970年5月至1998年3月间,日本信原病院1068例肩袖撕裂患者的1121个肩关节正位X线片和其临床患者资料。分别测量X线片上超过... 详细信息

目的回顾性分析肩袖撕裂患者术前肩关节X线片显示的肩峰骨棘的形态学变化,探讨与其合并肩袖撕裂的关系。方法依据1970年5月至1998年3月间,日本信原病院1068例肩袖撕裂患者的1121个肩关节正位X线片和其临床患者资料。分别测量X线片上超过1mm的肩峰骨棘大小(A级为≥1～5mm,B级为≥5～10mm,C级为≥10mm)及肩峰下间隙(又称作肩峰与肱骨头间距离,AHI)。临床患者资料分析包括患者的年龄、性别、肩关节疾病史及既往病史,治疗、手术经过等。结果根据肩峰骨棘的形态学变化,本文将肩峰形态分为六型,Ⅰ型(正常肩峰47.6%),Ⅱ型(肩峰下平面的骨棘16.5%),Ⅲ型(外侧肩峰的骨棘3.3%),Ⅳ型(喙肩韧带方向的骨棘11.9%),Ⅴ型(肩锁关节的退变20.4%),Ⅵ型(肩峰的双边征象17.8%);其中534肩(47.6%)无肩峰骨棘(12～87岁,平均54.1岁);587肩(52.4%)有肩峰骨棘(17～83岁,平均59.4岁);肩峰骨棘的患者中467个肩(41.7%)的骨棘为A级,112个肩(10%)为B级,8个肩(0.7%)为C级。801个肩(71.5%)的肩袖撕裂是由创伤所致;不明原因的肩袖撕裂有201个肩(17.9%);过度使用、积累性劳损的是119个肩(10.6%)。AHI的平均值为(8.7±2.6)mm,男性患者为(8.8±2.6)mm,女性患者为(8.4±2.7)mm,在有肩峰骨棘患者群中AHI为(8.4±2.7)mm,无肩峰骨棘患者群中AHI为(9.1±2.5)mm(t=2.93,P0.05)。肩峰骨棘患者群中51～60岁年龄组与61岁以上各年龄组间都有统计学差异(2=64.64,P<0.05)。结论肩关节X线片上肩峰骨棘的形态学分类,有助于医师认识和确诊患者患有肩峰骨棘。本研究认为肩峰骨棘与肩袖撕裂有明确相关性。随着患者年龄的增大,肩袖肌腱和肩峰骨质退行性变的发生,轻微的创伤都有可能导致肩袖撕裂。50岁以上的肩关节患者合并有肩峰骨棘,都应考虑其有肩袖撕裂的可能。

关键词：肩峰肩袖撕裂放射摄影术

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Usefulness of urinary trypsinogen-2 and trypsinogen activation peptide in acute pancreatitis:A multicenter study in Japan

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World Journal of Gastroenterology 2019年第1期25卷 107-117页

作者： hiroaki Yasuda Keisho Kataoka Yoshifumi Takeyama Kazunori Takeda Tetsuhide Ito Toshihiko Mayumi Shuji Isaji Tetsuya Mine Motoji Kitagawa Seiki Kiriyama Junichi Sakagami Atsushi Masamune Kazuo inui Kenji Hirano Ryukichi Akashi Masamichi Yokoe Yoshio Sogame Kazuichi Okazaki Chie Morioka Yasuyuki Kihara Shigeyuki Kawa Masao Tanaka Akira Andoh Wataru Kimura Isao Nishimori Junji Furuse Isao Yokota Tooru Shimosegawa Department of Medicine Division of Gastroenterology and Hepatology Kyoto Prefectural University of Medicine Department of Surgery Kindai University Faculty of Medicine Department of Surgery National Hospital Organization Sendai Medical Center Department of Medicine and Bioregulatory Science Graduate School of Medical Sciences Kyushu University Department of Emergency Medicine University of Occupational and Environmental Health Department of Hepatobiliary-Pancreatic and Transplant Surgery Mie University School of Medicine Department of Gastroenterology Tokai University School of Medicine Department of Nutritional Sciences Nagoya University of Arts and Sciences Department of Gastroenterology Ogaki Municipal Hospital Division of Gastroenterology Tohoku University Graduate School of Medicine Department of Gastroenterology Fujita Health University Bantane Hospital Department of Gastroenterology Graduate School of Medicine University of Tokyo Department of Healthcare Center Kumamoto Regional Medical Center General Internal Medicine Japanese Red Cross Nagoya Daini Hospital The Third Department of Internal Medicine Division of Gastroenterology and Hepatology Kansai Medical University Third Department of Internal Medicine Nara Medical University Department of Gastroenterology Kitakyushu General Hospital Department of Internal Medicine Matsumoto Dental University Department of Surgery and Oncology Graduate School of Medical SciencesKyushu University Division of Gastroenterology Department of Internal Medicine Shiga University of Medical Science Department of Gastroenterological General Breast and Thyroid SurgeryYamagata University Faculty of Medicine Department of Gastroenterology and Hepatology Kochi Medical School Faculty of Medicine Department of Medical Oncology Kyorin University Department of Biostatistics Hokkaido University

BACKGROUND Rapid urinary trypsinogen-2 dipstick test and levels of urinary trypsinogen-2 and trypsinogen activation peptide(TAP) concentration have been reported as prognostic markers for the diagnosis of acute *** To reconfirm the validity of all these markers in the diagnosis of acute pancreatitis by undertaking a multi-center study in *** Patients with acute abdominal pain were recruited from 17 medical institutions in Japan from April 2009 to December 2012. Urinary and serum samples were collected twice, at enrollment and on the following day for measuring target markers. The diagnosis and severity assessment of acute pancreatitis were assessed based on prognostic factors and computed tomography(CT) Grade of the Japanese Ministry of Health, Labour, and Welfare *** A total of 94 patients were enrolled during the study period. The trypsinogen-2 dipstick test was positive in 57 of 78 patients with acute pancreatitis(sensitivity,73.1%) and in 6 of 16 patients with abdominal pain but without any evidence of acute pancreatitis(specificity, 62.5%). The area under the curve(AUC) score of urinary trypsinogen-2 according to prognostic factors was 0.704, which was highest in all parameter. The AUC scores of urinary trypsinogen-2 and TAP according to CT Grade were 0.701 and 0.692, respectively, which shows higher than other pancreatic enzymes. The levels of urinary trypsinogen-2 and TAP were significantly higher in patients with extended extra-pancreatic inflammation as evaluated by CT *** We reconfirmed urinary trypsinogen-2 dipstick test is useful as a marker for the diagnosis of acute pancreatitis. Urinary trypsinogen-2 and TAP may be considered as useful markers to determine extra-pancreatic inflammation in acute pancreatitis.

关键词： Acute pancreatitis Trypsinogen activation peptide Urinary trypsinogen-2 dipstick test

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