四川省壤塘县120例藏族成人大骨节病患者手部影像学特点  

Radiological characteristics of 120 Tibetan adults with Kashin-Beck disease in Sichuan Province of China

作　　者：黄泽宇[1] 周宗科[1] 周轩[2] 沈彬[1] 邹翎[2] 罗磊[1] 杨静[1] 康鹏德[1] 裴福兴[1] 

机构地区：[1]四川大学华西医院骨科,成都610041 [2]四川大学华西医院放射科,成都610041

出　　处：《中国骨与关节外科》2012年第1期43-47,共5页Chinese Journal of Bone and Joint Surgery

摘　　要：背景:大骨节病(Kashin-Beck disease,KBD)是一种原因不明、以关节软骨和骺板软骨变性坏死为基本病变的地方性骨关节病。既往研究发现,几乎所有成人KBD患者均存在手部关节异常,手部关节的影像学改变特点是区分KBD和其他骨关节疾病的重要参考因素。目的:研究四川省阿坝州壤塘县藏族成人KBD患者手部X线片特征。方法:四川省阿坝州壤塘县120例藏族成人KBD患者为KBD组,选取年龄性别匹配的120位正常人作为对照组,均行双手前后位X线片检查,研究其影像学特点,测量KBD组及对照组右手近节和中节指骨指数。结果:KBD组120例,男42例,女78例;年龄为20～80岁,平均63.6岁。双手前后位X线片检查示方形骨端108例,喇叭状干骺端112例,腕骨拥挤113例,桡骨远端增粗及变短92例,指间关节半脱位57例,108例患者表现为关节间隙变窄、软骨下骨硬化及关节边缘骨赘增生等骨关节炎改变。KBD组男性患者及正常男性中指近节指骨指数分别为4.04及4.16(P=0.021),女性患者及正常女性分别为4.21及4.37(P=0.013)。结论:四川省阿坝州壤塘县藏族成人KBD患者手部X线片示方形骨端、喇叭状干骺端、腕骨拥挤、桡骨远端增粗变短、指间关节半脱位及骨关节炎改变。男、女患者近节指骨指数小于正常人群。Background： Kashin-Beck disease （KBD） is an unexplained local bone and joint disease. Articular cartilage and epiphyseal plate cartilage degeneration and necrosis are the typical manifestations of KBD. Previous studies have shown that almost all adult KBD patients have hand joint abnormalities and radiological changes of the hand joints is characterized as aa impmtom sign to distingush it from the other bone and joint diseases.Objective： The purpose of the present study is to study radiological characteristics in hands and wrists of Tibetan adults with KBD in Sicbuan of China.Methods： Totally 120 Tibetan adults with KBD were involved in this study. Among them there were 42 males and 78 females with a mean age of 63. 6 （20 -80） years old. Hand and wrist radiographs were taken and the indexes of both middle and proximal were measured.Results： Among them there were 108 patients with square ends of the bones, 112 patients with horn-like metaphysis, 113 patients with crowding carpal bones, 92 patients with shorten and enlarged distal radius, 108 patients with osteoarthritis- like ehanges and 57 patients with interphalangeal joint subluxation. The mean proximal phalanx index of male patients and mmnal males was 4. 04 and 4. 16 （P = 0. 021 ）. The mean proximal phalanx index of female patients and normal females was4.21 and4.37 （P=0. 013）.Conclusions： Square ends of the bones, horn-like metaphysis, crowding carpal bones, shorten and enlarged distal radius, osteoarthritis-like changes and interphalangeal joint subluxation are the main radiologieal characteristics of Tibetans with KBD in lids area. The proximal phalangeal indexes of both male and female patients are smaller than the normal ones.

关 键 词：成人大骨节病 X线片 指骨指数 藏族 

分 类 号：R684.1[医药卫生—骨科学]