湖南省农村居民腰椎间盘突出的危险因素及预测模型研究  

Study on risk factors and predictive model for lumbar intervertebral disc herniation in the rural population

作　　者：张斯钰[1] 黄鹏[1] 黄昕[1] 陈婷[1] 赵鑫[1] 梁翠敏[1] 李林香[1] 谭红专[1] 

机构地区：[1]中南大学公共卫生学院流行病与卫生统计学系,长沙410078

出　　处：《中华流行病学杂志》2009年第11期1152-1155,共4页Chinese Journal of Epidemiology

摘　　要：目的探索农村居民腰椎间盘突出的危险因素，并建立患病预测模型。方法采用以人群为基础的病例对照研究方法，在湖南省某市3个乡50123名居民中确诊的腰椎间盘突出症患者303例中，随机选择152例为病例组，选择与病例组在性别和年龄段构成相似的健康居民167人为对照组，问卷调查各种可能危险因素的暴露情况，建立logistic预测模型。结果非条件logistic回归分析结果显示阳性腰椎疾患家族史、腰部诊疗或手术、紧张心理、腰背部急性损伤、固定工作体位和BMI≥23．0kg／m。是该地区居民腰椎间盘突出的危险因素。由此建立的logistic预测模型受试者工作特征曲线下面积达到0．809，当概率分界点设为0．4时，预测准确率为74．0％，灵敏度为73，7％，特异度为74．3％。结论农村居民腰椎间盘突出症的发生受到遗传和环境多因素的影响，通过建立的logistic回归模型可以实现预测。Objective To explore the risk factors on the symptoms of lumbar intervertebral disc herniation so as to develop a predictive model for the disease. Methods With a populationbased case-control study, 303 of 50 123 residents were diagnosed as having lumbar intervertebral disc herniation symptoms. 152 cases and 167 healthy controls, matched by gender and age, were randomly chosen as case and control groups. Questionnaires were used to collect information on the exposure to risk factors and logistic predictive model was then established. Results Through non-conditional logistic regression analysis, data showed that the positive family history of lumbar vertebra disorder, lumbar treatment or surgery, mental stress, acute low back injury, permanent work pose, and body mass index ≥23.0 kg/m^2 were the risk factors among residents from the countryside. The area under the receiver operator characteristic curve of logistic predictive model was 0.809. When 0.4 was set as the classification cutoff, the total predictive correct rate, sensitivity, and specificity were 74.0%, 73.7%, and 74.3% respectively. Conclusion The occurrence of lumbar disk herniationcan in countryside population was affected by multi-variables including genetic and environmental, and could be predicted with the logistic regression model established by our group. The positive predictive results could be used to alarm the patients and doctors for prevention and treatment of the disease.

关 键 词：腰椎间盘突出症 病例-对照研究 流行病学 模型 

分 类 号：R681.8[医药卫生—骨科学]