X线测量在半月板损伤诊疗中的临床价值  

Clinical value of X-ray measurement in the diagnosis of meniscus injury

作　　者：殷华 胡光锋 李洪飞 YIN Hua;HU Guangfeng;LI Hongfei(Department of Medical Imaging,Huangshan Vocational and Technical College,Huangshan 245000,China;Department of Orthopedics,Huangshan Shoukang Hospital;Shenyang 15th Retired Cadres'Center of Liaoning Province Military Command)

机构地区：[1]安徽省黄山市黄山职业技术学院医学影像教研室,安徽黄山245000 [2]黄山首康医院骨科 [3]辽宁省军区沈阳第十五离职干部休养所

出　　处：《沈阳医学院学报》2023年第2期141-144,共4页Journal of Shenyang Medical College

基　　金：安徽省2021年度高等学校省级质量工程项目(No.2021kcszsfkc390)。

摘　　要：目的:探讨X线测量在半月板损伤诊疗中的临床价值。方法:回顾性分析2016年1月至2020年12月黄山首康医院247例膝骨关节炎患者的临床资料,患者按是否存在半月板损伤被分为研究组(177例,存在半月板损伤)与对照组(70例,无半月板损伤)。比较2组患者X线测量参数,计算X线测量诊断半月板损伤的灵敏度,结合计算结果采用受试者工作特征(ROC)曲线分析X线测量对半月板损伤的诊断效能,采用Logistic回归模型分析X线测量参数与患者半月板损伤程度间的相关性。结果:研究组(存在半月板损伤)患者的X线测量参数与对照组(无半月板损伤)比较差异有统计学意义(P<0.05)。X线诊断结果显示,X线测量诊断半月板损伤的灵敏度为94.92%(168/177)、特异度为87.14%(61/70)、符合率为92.71%(229/247),X线测量诊断半月板损伤的AUC为0.811(95%CI:0.887~0.919)。Logistic回归模型显示,内侧胫骨平台深度减小(OR=1.152,95%CI:0.322~0.573)、胫骨冠状倾斜角增大(OR=1.279,95%CI:0.395~0.552)、膝关节内翻角增大(OR=1.769,95%CI:0.519~0.765)、内侧胫骨平台后倾角增大(OR=1.957,95%CI:0.735~0.899)是膝骨关节炎患者半月板损伤程度加剧的危险因素(P<0.05)。结论:X线测量参数能够对膝骨关节炎患者半月板损伤情况及损伤程度作出科学评估。Objective:To explore the clinical value of X-ray measurement in the diagnosis of meniscus injury.Methods:Clinical data of 247 patients with knee osteoarthritis in Huangshan Shoukang Hospital from Jan 2016 to Dec 2020 were analyzed retrospectively.According to whether the patients had meniscus injury,they were divided into the research group(177 cases,with meniscus injury)and the control group(70 cases,without meniscus injury).The X-ray measurement parameters of the two groups were compared,and the sensitivity of X-ray measurement in the diagnosis of meniscus injury was calculated.Combined with the calculation results,the receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficiency of X-ray measurement for meniscus injury,and the correlation between X-ray measurement parameters and the degree of meniscus injury was analyzed by logistic regression model.Results:There was significant difference in X-ray measurement parameters between the research group and the control group(P<0.05).Results of X-ray diagnosis showed that the sensitivity of X-ray measurement in the diagnosis of meniscus injury was 94.92%(168/177),the specificity was 87.14%(61/70),and the coincidence rate was 92.71%(229/247).The AUC of X-ray measurement in the diagnosis of meniscus injury were 0.811(95%CI:0.887-0.919).Logistic regression model showed that the decrease of medial tibial plateau depth(OR=1.152,95%CI:0.322-0.573),the increase of tibial coronal inclination angle(OR=1.279,95%CI:0.395-0.552),the increase of knee varus angle(OR=1.769,95%CI:0.519-0.765)and the increase of medial tibial plateau caster angle(OR=1.957,95%CI:0.735-0.899)were risk factors for the aggravation of meniscus injury in patients with knee osteoarthritis(P<0.05).Conclusion:X-ray measurement parameters can make a scientific evaluation of meniscus injury degree in patients with knee osteoarthritis.

关 键 词：X线 膝骨关节炎 解剖学参数 半月板损伤 

分 类 号：R684.7[医药卫生—骨科学]