Risser征对特发性脊柱侧凸患者生长潜能评估的组织学研究  

Assessment of the residual spine growth potential in idiopathic scoliosis by Risser sign and histological grading

作　　者：王守丰[1] 邱勇[1] 朱泽章[1] 朱锋[1] 马兆龙[1] 夏才伟[1] 

机构地区：[1]南京大学医学院附属鼓楼医院脊柱外科,210008

出　　处：《中华医学杂志》2008年第7期461-464,共4页National Medical Journal of China

基　　金：江苏省卫生厅科研重大项目（K200610）

摘　　要：目的探讨Risser征对特发性脊柱侧凸（IS）患者的脊柱生长潜能的相关性。方法对39例IS患者椎体生长板组织学分级（HGs）、Risser分级、患者月经状况和社会学年龄进行相关性分析。结果Risser 0级时，所有患者椎体生长板具有生长活性。6例Risser4级的患者椎体生长板组织学表现为Ⅱ度生长活性。Risser5级时，所有椎体生长板没有生长活性。39例IS患者Risser征分级与椎体生长板HG存在明显负相关（Spearman’s rs=-0．645，P=0．000，〈0．05）。Risser4级患者HG与月经状态（初潮至手术时的时间）存在明显负相关（Spearman’s rs=-0．710，P=0．002）。在Risser0～1级的患者和Risser2～5级的患者之间，生长潜能差异有统计学意义（P=0．020）。结论Risser征是临床评估IS患者生长潜能方便易行的指标，但必须结合患者的月经状态和社会学年龄才能正确评估IS患者脊柱的生长潜能。Objective To investigate the correlation between histological grade （HG） of vertebral growth plates and Risser grade in the female idiopathic scoliosis （IS） patients; and to identify whether Risser grading is a reliable indicator for accurate evaluation of the spinal residual growth potential. Methods Thirty- nine samples of vertebral growth plates obtained during operation from 15 females IS patients, all female, aged 15. 1 （ 12. 4 - 18.0）, underwent HE staining and light microscopy to determine the values of HG. X- ray photography of pelvis was conducted before operation to identify the Risser sign. The correlation of Risser grade with pubertal status was analyzed. Results All the vertebral growth plates of the IS patients with the Risser grade of 0 showed growth activity. The vertebral growth plates showed HG H activity in 6 of the 16 IS patients with the Risser grade of 4. All the vertebral growth plates showed no growth activity in the 3 IS patients with the Risser grade of 5. There was a negative correlation between the HG and Risser grade in all 39 patients （ r = - 0. 645, P = 0. 000）. The HG of the patients with the Risser grade of 4 was negatively correlated with the menarchal status （time between menarche and operation） （r = -0. 710, P = 0. 002）. The residual growth potential of spinal growth plates of the patients with the Risser grades of 2 - 5 was significantly lower than of the patients with the Risser grades of 0 - 1 （ P = 0. 020）. Conclusion Risser sign may be a reliable indicator for predicting the spinal residual growth potential in IS patients, but it should be correlated with menarchal status and chronological ages.

关 键 词：脊柱侧凸 组织学 比较 Risser征 

分 类 号：R686[医药卫生—骨科学]