青少年特发性脊柱侧凸患者存在异常的脊柱骨盆生长发育模式  

Abnormal growth of spine in patients with adolescent idiopathic thoracic scoliosis

作　　者：鲍虹达 刘臻[1] 邱勇[1] 朱锋[1] 朱泽章[1] 张文[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：《中华外科杂志》2014年第5期350-354,共5页Chinese Journal of Surgery

基　　金：卫生部卫生行业科研专项资助项目（201002018）

摘　　要：目的 比较单胸弯青少年特发性脊柱侧凸（T-AIS）患者与同龄健康青少年脊柱骨盆生长发育模式情况.方法 研究对象包括2011年12月至2012年10月就诊的48例女性T-AIS患者（T-AIS组）和48例同龄健康女孩（正常对照组）,年龄10～18岁.在站立位全脊柱正位X线片上测量两组研究对象的全脊柱长度及高度（LOS和HOS）、T1～T12胸椎长度及高度（LOT和HOT）、骨盆高度及宽度（HOP和WOP）以及胸廓宽度（WOT）,并计算HOS/HOP、LOS/HOP、LOS/LOT、WOT/WOP4组比值.对两组间的测量指标及比值进行独立样本t检验.结果 T-AIS组患者的HOS及HOT均显著小于正常对照组青少年（t=2.060和3.359,P=0.042和0.001）,但是其LOS及LOT均显著大于正常对照组青少年（t=-2.364和-1.495,P=0.020和0.043）,而两组之间的WOP、HOP及WOT差异均无统计学意义（P＞0.05）.此外,正常对照组的LOS/HOP为2.26±0.14,而T-AIS组患者LOS/HOP、LOT/HOP均显著大于正常对照组.T-AIS组患者的LOS/LOT比值与正常对照组相比较为稳定,显示了T-AIS患者胸椎纵向生长速率较腰椎快.结论 T-AIS患者的真实全脊柱长度及胸椎长度均显著大于同龄正常青少年,且胸椎纵向生长速率较腰椎生长速率快;而骨盆的宽度和高度未见明显差异.Objective To investigate if the growth patterns of the spine and pelvis are consistent in adolescent idiopathic scoliosis （AIS） patients with single thoracic curves. Methods Forty-eight thoracic adolescent idiopathic scoliosis （T-AIS） female patients and 48 healthy age-matched adolescents were recruited consecutively between December 2011 and October 2012. Radiographic parameters including height of spine （ HOS）, length of spine （ LOS）, height of thoracic spine （ HOT）, length of thoracic spine （ LOT）, height of pelvis （ HOP）, width of pelvis （WOP） and width of thorax （WOT） were measured on the long- cassete posteroanterior standing radiographs. In addition, ratios including HOS/HOP, LOS/HOP, HOT/ HOP, LOT/HOP, LOS/LOT, WOT/WOP were also calculated. Independent t-test was performed to compare the radiographic parameters and ratios between the two groups. Results Compared to the age- matched healthy adolescents, T-AIS patients had a significantly higher LOS and LOT （ t = - 2. 364 and -1.495,P=0.020 and 0.043） and smaller HOS and HOT （t =2.060 and 3. 359, P =0.042 and 0. 001 ）. Yet, all of HOP, WOP and WOT showed no significant difference between T-MS patients and healthy adolescents. Similarly, LOS/HOP and LOT/HOP were significantly higher in T-AIS patients as may be expected with an average LOS/HOP of 2. 26 ± 0. 14 in normal controls. In addition, LOS/LOT in normal controls had a trend of increase with age which was different from the stable LOS/LOT in T-AIS patients, indicating an increased growth of thoracic vertebra compared to lumbar vertebra. Conclusions Compared to the age-matched healthy adolescents, T-AIS patients have an abnormal growth characteristics with longer spine. The growth of pelvis and thorax show no significant differences between T-AIS patients and healthy adolescents.

关 键 词：脊柱侧凸 青少年 人体测量术 生长和发育 

分 类 号：R682.3[医药卫生—骨科学]