椎体CT值对原发性骨质疏松症唑来膦酸钠疗效的评价价值  

Predictive value of changes in CT value of vertebral body for the efficacy of zoledronate sodium in pri-mary osteoporosis

作　　者：雷礼辉 李峰 罗光平[1] 刘洪[1] 杨骐彰 吴涛 翁睿 Lei Lihui;Li Feng;Luo Guangping;Liu Hong;Yang Qizhang;Wu Tao;Weng Rui(Department of Spine Surgery,Huaihua First People's Hospital,Huaihua 418000,China;Department of Im-aging,Hunan Medical College,Huaihua 418000,China;Department of Orthopedics,the First Affiliated Hospital of Hunan Medical College,Huaihua 418000,China)

机构地区：[1]怀化市第一人民医院脊柱外科,418000 [2]湖南医药学院影像科,怀化418000 [3]南医药学院第一附属医院骨科,怀化418000

出　　处：《中华老年骨科与康复电子杂志》2022年第5期285-289,共5页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：湖南省自然科学基金项目(2015JJ4037)。

摘　　要：目的探讨椎体CT值变化对原发性骨质疏松症(OP)唑来膦酸钠疗效的评价价值。方法选取2018年5月至2021年4月医院收治的152例原发性OP患者为研究对象,所有患者均采用唑来膦酸钠治疗,统计治疗后12个月疗效。收集患者临床资料,采用Logistic回归分析影响原发性OP患者唑来膦酸钠治疗疗效的因素,用受试者工作特征(ROC)曲线分析影响因素对原发性OP唑来膦酸钠疗效的评价价值。结果152例原发性OP患者脱落2例,剩余150例患者中59例患者疗效满意,91例患者疗效不佳。将单因素分析有统计学意义的LDLC水平、25-羟维生素D、腰椎体骨松质L1△CT值为自变量进行Logistic回归分析,结果显示腰椎体骨松质L1△CT值(OR=4.084,95%CI:1.680,9.925)、25-羟维生素D(OR=3.640,95%CI:1.498,8.847)是影响原发性OP唑来膦酸钠疗效的独立因素(P<0.05)。ROC曲线显示腰椎体骨松质L1△CT值评价原发性OP唑来膦酸钠疗效的AUC高于25-羟维生素D(P<0.05)。结论原发性OP患者存在唑来膦酸钠治疗疗效不佳风险,椎体CT值变化、25-羟维生素D水平与原发性OP唑来膦酸钠疗效有关,且二者评价原发性OP唑来膦酸钠疗效效能良好。Objective To explore the predictive value of CTvalue changes of vertebral body for the effi-cacy of zoledronate sodium in primary osteoporosis(OP).Methods 152 patients with primaryOPwho were ad-mitted to the hospital from May 2018 to April 2021 were selected as the research objects.All patients were treated with zoledronic sodium,and the curative effect was calculated 12 months after treatment.Patient clinical data were collected.Logistic regression was used to analyze the factors that affect the efficacy of zoledronate in pa-tients with primaryOP.Receiver operating characteristic(ROC)curve was used to analyze the evaluation value of influencing factors on the efficacy of zoledronate in primary OP.Results 2 patients dropped out.Among the re-maining 150 patients,59 patients had satisfactory curative effects,and 91 patients had poor curative effects of the 152 patients with primaryOP.Logistic multivariate regression analysis showed that lumbar vertebral body cancel-lous bone L1△CT value(OR=4.084,95%CI:1.680,9.925),25-hydroxyvitamin D(OR=3.640,95%CI:1.498,8.847)were the influencing factors Independent factors for the efficacy of zoledronate sodium in patients with OP.TheROCcurve showed that theAUCof lumbar vertebral cancellous boneL1△CTvalue in evaluating the ef-ficacy of primary OPzoledronate was higher than that of 25-hydroxyvitamin D.Conclusions Patients with pri-mary OP are at risk of poor efficacy of zoledronate treatment.The changes of vertebral CT value and 25-hy-droxyvitaminDlevel are related to the efficacy of zoledronate in primaryOP.OPzoledronate has good efficacy.

关 键 词：原发性骨质疏松症 椎体CT值 唑来膦酸钠疗效 评价价值 

分 类 号：R687.3[医药卫生—骨科学]