血清25-羟基维生素D水平与踝关节骨髓水肿综合征的相关性研究  

Correlation between serum 25-hydroxyvitamin D level and ankle bone marrow edema syndrome

作　　者：倪广晓[1] 周广 孙伟力[1] 孟然[1] 封英发 王璞[4] NI Guang-xiao;ZHOU Guang;SUN Wei-li;MENG Ran;FENG Ying-fa;WANG Pu(The First Department of Rehabilitation Medicine,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Stomatology,the People′s Hospital of Nanpi County,Hebei Province,Nanpi 061500,China;Department of Orthopedics,the Fourth Hospital ofHebei Medical University,Shijiazhuang 050011,China;Department of Prosthodontics,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院康复医学一科,河北石家庄050000 [2]河北省南皮县人民医院口腔科,河北南皮061500 [3]河北医科大学第四医院骨科,河北石家庄050011 [4]河北医科大学第二医院口腔修复科,河北石家庄050000

出　　处：《河北医科大学学报》2018年第11期1334-1338,共5页Journal of Hebei Medical University

摘　　要：目的探讨血清25-羟基维生素D[25-(OH)D]水平与踝关节骨髓水肿综合征(bone marrow edema syndrome,BMES)之间的相关性。方法回顾性分析确诊的93例踝关节BMES患者血清25-(OH)D水平与年龄、性别、美国足踝外科协会踝-后足评分系统(American Orthopedic Foot and Ankle Society,AOFAS)评分、视觉模拟评分法(Visual Analogue Scale,VAS)评分及踝关节受累骨骼数量之间的关系。结果 93例患者25-(OH)D水平在17.69～57.07nmol/L之间,平均(32.6±11.8)nmol/L,83.9%(78/93)的患者25-(OH)D水平低于50nmol/L,其中61.3%的患者(57/93)为维生素D缺乏症,22.6%的患者(21/93)维生素D不足,只有16.1%(15/93)患者25-(OH)D水平≥50nmol/L。所有患者AOFAS评分为44.90～94.60分,平均(63.1±12.8)分;VAS评分为1.0～10.0分,平均(5.6±2.1)分;踝关节受累骨骼数目为2～7块,平均(4.2±1.6)块。不同性别BMES患者25-(OH)D水平差异无统计学意义(P>0.05)。Pearson相关分析显示,25-(OH)D水平与AOFAS评分呈正相关(r=0.907,P<0.05),与VAS评分及骨髓水肿受累骨骼数量呈负相关(r=-0.832、r=-0.707,P<0.05),与年龄无明显相关性(r=-0.082,P>0.05)。多元线性回归分析显示,25-(OH)D水平与AOFAS评分及VAS评分相关性最强,25-(OH)D水平与AOFAS评分呈正相关,与VAS评分呈负相关(标准化偏回归系数=0.593、-1.615,P<0.05)。结论血清25-(OH)D水平与踝关节BMES患者的关节功能、疼痛程度及受累骨骼数目均相关,并且与AOFAS评分及VAS评分密切相关。因此,低水平维生素D可能是踝关节BMES发病及病程进展的重要影响因素,补充维生素D可以作为预防治疗BMES的新靶点。Objective To investigate the relationship between level of serum 25-hydroxyvitamin D[25-（OH）D] and ankle bone marrow edema syndrome.Methods We made a retrospective analysis of clinical date of ninety three patients who were diagnosed with BMES in ankle joint. Pearson′s linear correlation analysis and multiple linear regression analysis were used to analyze the relationship between serum 25-（OH）D levels and American Orthopedic Foot and Ankle Society（AOFAS） scores, Visual Analogue Scale（VAS） scores, age, sex and number of affected bones.Results In all 93 patients, the serum levels of 25-（OH）D ranged from 17.69 to 57.07nmol/l with an average serum 25-（OH）D levels of （32.6±11.8） nmol/l, and 83.9%（78/93） of patients had low vitamin D levels with serum levels of 25-（OH）D below 50 nmol/l, 61.3%（57/93） of patients were vitamin D deficient, 22.6%（21/93）of patients were vitamin D insufficient, and only 16.1%（15/93） patients had sufficient vitamin D levels（serum levels of 25-（OH）D≥50 nmol/l）. In All patients , the AOFAS scores ranged from 44.90 to 94.60, with an average of 63.1±12.8. The VAS scores ranged from 1.0 to 10.0, with an average of 5.6±2.1. The number of affected ankle bones ranged from 2 to 7, with an average of 4.2 ± 1.6. Statistical analysis showed no significant difference comparing vitamin D levels with sex of patients（ P 〉 0.05）. Pearson correlation analysis showed that the serum levels of 25-（OH）D was positively correlated with the AOFAS scores（ r = 0.907 , P 〈 0.05）, and negatively correlated with the VAS scores and the number of affected ankle bones（ r = -0.83 2, r = -0.707 , P 〈 0.05）. There was no significant correlation with age（ r = -0.082 , P 〉 0.05）. By multiple linear regression analysis, the correlation between AOFAS scores , VAS scores and the serum levels of 25-（OH）D was strongest, the serum levels of 25-（OH）D was positively correlated with AOFAS scores, and negatively correlated with VAS score

关 键 词：踝关节 骨髓水肿综合征 维生素D 

分 类 号：R442.8[医药卫生—诊断学]