国人膝骨关节炎患者关节线不均匀沉降的影像学测量及影响因素分析  

Imaging measurements and influencing factors of non-uniform settlement of joint line in patients with knee osteoarthritis

作　　者：吴海贺 左建林[1] 李钊 杨育晖[1] 刘潼[1] 高忠礼[1] 

机构地区：[1]吉林大学中日联谊医院骨科,长春130033

出　　处：《中华老年骨科与康复电子杂志》2018年第2期105-110,共6页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：吉林大学研究生创新基金(2017043)

摘　　要：目的通过测量膝骨关节炎(KOA)患者X线基本参数,探究膝关节线重塑及不均匀沉降规律及影响因素。方法本研究共纳入2015年1月至2016年12月吉林大学中日联谊医院收治的148例(192膝)KOA患者,其中男性50例(59膝),女性98例(133膝);年龄41~81岁,平均(64±9)岁。将所有患者按年龄分成<60岁组和≥60岁组,并按K-L分级对KOA患者进行分型。在膝关节正位X线片上测量解剖标志到膝关节线的距离、股骨髁高度及胫骨平台高度并进行统计分析。结果股骨内收肌结节、腓骨头高点到膝关节线的距离分别为(50±5)mm(ATJL)、(17±5)mm(FHJL)。股骨内髁(MFCA)、股骨外髁(LFCA)、胫骨内侧平台(MTPA)、胫骨外侧平台(LTPA)高度分别为(49±5)mm、(47±6)mm、(4±5)mm、(9±4)mm。股骨髁宽度(FW)为(93±7)mm,并与ATJL呈正相关(r=0.651,P<0.001)。不同性别间FW、ATJL、MFCA、LFCA差异具有统计学意义(P<0.05)。<60岁和≥60岁组间MTPA差异具有统计学意义(t=2.195,P=0.029)。不同K-L分级MTPA差异具有统计学意义(F=4.082,P=0.003),且MTPA与K-L分级呈负相关(r=-0.241,P=0.001)。结论胫骨内侧平台高度与KOA严重程度呈负相关,可以用来评价KOA的严重程度。在KOA患者中ATJL与FW具有相关性,随着年龄的增长股骨髁及胫骨外侧平台高度未发生明显变化,胫骨内侧平台高度显著降低,提示胫骨平台随年龄增长存在不均匀沉降。Objective To explore the rule and influencing factors of knee joint line remodeling aswell as non-uniform settlement through measuring basic parameters of X-ray in patients with knee osteoarthritis（KOA）. Methods A retrospective study was done in148 patients （total 192 knees） treated in China–Japan Union Hospital of Jilin University from January 2015 to December 2016, including 50 males （59knees） and 98 females （133 knees）. Aged from 41 to 81 years with a mean age of 64±9 years. Patients weredivided into 〈60 years Group and ≥60 years Group. All knee joints were classified by K-L grade. The distancebetween the knee anatomical landmarks and the knee joint, the altitude of femoral condyle and tibialplatform were first measured and then analyzed on a standard knee anteroposterior radiograph. Results Thedistances from femoral adductor tubercle and the apex of fibular head to knee line were （50±5） mm （ATJL）and （17±5） mm （FHJL）, respectively. The altitudes of medial and lateral femoral condyle, medial and lateraltibial plateau were （49±5） mm （MFCA）, （47±6） mm （LFCA）, （4±5） mm （MTPA） and （9±4） mm （LTPA）, respectively.The femoral width （FW） was （93±7） mm which was positively correlated with ATJL （r=0.651, P〈0.001）. The differences of FW, ATJL, MFCA, LFCA in gender were statistically significant （P〈0.05）. Therewas statistically different in MTPA between two different age groups （t=2.195, P=0.003）. According to the KLgrade, there existed statistically significant difference between two groups （F=4.082, P=0.003）, and MTPAwas negatively correlated with the K-L grade （r=-0.241, P=0.001）. Conclusions The MTPA is negatively correlated with the severity of KOA, which can be used to evaluate the severity of KOA. There was a correlationbetween ATJL and FW in KOA patients. The height of the lateral femoral condyle and lateral tibial plateaudid not change significantly with increased age, and the height of medial tibial platea

关 键 词：膝关节 内收肌结节 不均匀沉降 

分 类 号：R684.3[医药卫生—骨科学]