非特异性腰痛患者椎旁多裂肌脂肪浸润程度与性别、年龄、影像学参数的相关性分析  

Correlation analysis of the degree of fat infiltration of paravertebral multifidus muscle with gender,age and imaging parameters in patients with nonspecific low back pain

作　　者：潘富伟 郎珈望 张旻[2] 陈元川[1] 杨光月[1] 李正言[1] 詹红生[1,2] PAN Fu-wei;LANG Jia-wang;ZHANG Min;CHEN Yuan-chuan;YANG Guang-yue;LI Zheng-yan;ZHAN Hong-sheng(SHIs’Center of Orthopedics and Traumatology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Institute of Traumatology&Orthopedics,Shanghai Academy of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院石氏伤科医学中心,上海201203 [2]上海市中医药研究院骨伤科研究所,上海201203

出　　处：《中华中医药杂志》2023年第3期1274-1280,共7页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.82074466,No.81973875);上海市临床重点专科“中医骨伤科学”(No.shslczdzk03901);上海市慢性筋骨病临床医学研究中心(No.20MC1920600);促进市级医院临床技能与临床创新三年行动计划(2020-2022年)重大临床研究项目(No.SHDC2020CR1051B);上海市中西医临床协作试点项目[No.ZXYXZ-201703,No.ZY(2018-2020)-FWTX-1007];2021年度上海中医药大学“研究生创新培养专项”(No.Y2021088)。

摘　　要：目的:分析非特异性腰痛患者椎旁多裂肌脂肪浸润程度与性别、年龄、影像学参数的相关性,为该病的临床诊治、预后判断提供客观的参考依据。方法:本研究为回顾性研究,采用基于化学位移的水脂分离技术测定200例符合条件的研究对象L3-4、L4-5、L5-S1双侧椎旁肌多裂肌脂肪含量,影像学参数:L3-4、L4-5、L5-S1椎间盘Pfirrmann分级、关节突关节骨关节炎(FJOA)分级,L3-S1前凸角,L3-4、L4-5、L5-S1的椎间隙高度指数(IHI)。并分析椎旁多裂肌脂肪浸润程度与性别、年龄、影像学参数的相关性。结果:非特异性腰痛患者L3-4、L4-5、L5-S1椎旁多裂肌脂肪浸润程度不仅和性别、年龄存在相关性,还与L3-S1前凸角、Pfirrmann、FJOA分级影像学参数均具有显著的正相关关系(P<0.05,P<0.01)。L3-4、L4-5椎旁多裂肌脂肪浸润程度和IHI之间有着显著的负相关关系(P<0.01,P<0.05)。结论:“筋伤”在非特异性腰痛发生、发展中起重要作用,在临床中要重视“筋伤”这一关键的病理环节。Objective:To analyze the correlation between the degree of fat infiltration of paraxial multifidus muscle and gender,age and imaging parameters in patients with nonspecific low back pain,so as to provide objective reference for clinical diagnosis and treatment and prognosis judgment of this disease.Methods:This study is a retrospective study.The fat infiltration in bilateral paracrinal muscle multifidus muscle of 200 eligible subjects L3-4,L4-5 and L5-S1 was measured by waterfat separation technique based on chemical displacement.The pfirrmann grading of L3-4,L4-5 and L5-S1,the FJOA grading of L3-4,L4-5 and L5-S1,the lordosis of L3-S1,the intervertebral space height index of L3-4,L4-5 and L5-S1 were measured too.To analyze the correlation of fat infiltration degree of paravertebral multifidus muscle with sex,age and imaging parameters.Results:The fat infiltration degree of L3-4,L4-5 and L5-S1 paravertebral multifidus muscle in patients with nonspecific low back pain was not only correlated with gender and age,but also significantly positively correlated with L3-S1 lordosis,Pfirrmann and FJOA grading imaging parameters(P<0.05,P<0.01).There was a significant negative correlation between the degree of fat infiltration in L3-4 and L4-5 paravertebral multifidus and IHI(P<0.01,P<0.05).Conclusion:‘Tendon injury’plays an important role in the occurrence and development of nonspecific low back pain,and we should pay attention to this key pathological link in clinic.

关 键 词：非特异性腰痛 多裂肌 脂肪浸润 影像学 相关性分析 筋伤 

分 类 号：R681.5[医药卫生—骨科学]