绝经后女性椎旁肌退化与经皮穿刺椎体成形后再骨折的相关性  

Relationship between degeneration of paraspinal muscle and refractures in postmenopausal women treated by percutaneous vertebroplasty

作　　者：杨策凯 蔡卓延 陈明[1] 刘昊 翁汭 崔健超[4] 张顺聪[4] 姚珍松[1,2,4] Yang Cekai;Cai Zhuoyan;Chen Ming;Liu Hao;Weng Rui;Cui Jianchao;Zhang Shuncong;Yao Zhensong(Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China;Baiyun Hospital of First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510000,Guangdong Province,China;Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510000,Guangdong Province,China;Department of Spinal Orthopedics,First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China)

机构地区：[1]广州中医药大学,广东省广州市510405 [2]广州中医药大学第一附属医院白云医院,广东省广州市510000 [3]广州中医药大学第三附属医院,广东省广州市510000 [4]广州中医药大学第一附属医院脊柱骨科,广东省广州市510405

出　　处：《中国组织工程研究》2024年第9期1414-1419,共6页Chinese Journal of Tissue Engineering Research

基　　金：广东省中医药局科研项目(20201097),项目负责人:崔健超。

摘　　要：背景:目前关于绝经后女性椎旁肌退化程度对经皮穿刺椎体成形后骨质疏松性椎体再骨折的影响研究较少,此次研究旨在揭示二者之间的联系。目的:探讨绝经后女性椎旁肌退化与经皮穿刺椎体成形后骨质疏松性椎体再骨折的关系。方法:回顾性分析2018年5月至2021年3月广州中医药大学第一附属医院收治的81例因骨质疏松性椎体压缩骨折住院接受经皮穿刺椎体成形治疗的绝经后女性患者的病历资料,根据患者是否发生经皮穿刺椎体成形后骨质疏松性椎体再骨折分为2组,再发骨质疏松性椎体压缩骨折组39例,对照组42例。分析两组患者一般资料、椎体骨矿物密度、椎旁肌的横截面积及平均CT值(Hu)。结果与结论:①单因素分析提示,两组患者的年龄及腰大肌平均CT值相比差异无显著性意义(P>0.05);对照组的体质量指数、椎体骨密度、椎旁肌横截面积及椎后肌群的平均CT值明显高于再发骨质疏松性椎体压缩骨折组,差异有显著性意义(P<0.05);②多因素logistic回归分析提示,低椎体骨矿物密度(OR=0.004,95%CI:0.000-0.555,P<0.05)、低椎后肌群平均CT值(OR=0.940,95%CI:0.894-0.988,P<0.05)是绝经后骨质疏松性再发椎体压缩骨折的独立危险因素;③提示椎旁肌退化会导致经皮穿刺椎体成形后再骨折风险增高,其中椎后肌群平均CT值较低的绝经后女性,行经皮穿刺椎体成形后再发生椎体压缩骨折的风险较高。BACKGROUND:There are few studies on the effect of degeneration of paraspinal muscle on osteoporotic vertebral compression refractures treated by percutaneous vertebroplasty in postmenopausal women.This paper intends to reveal the relationship between them.OBJECTIVE:To investigate the relationship between degeneration of paraspinal muscle and osteoporotic vertebral compression refractures in postmenopausal women treated by percutaneous vertebroplasty.METHODS:The medical records of 81 postmenopausal female patients who were admitted to the First Affiliated Hospital of Guangzhou University of Chinese Medicine from May 2018 to March 2021 for osteoporotic vertebral compression fracture and received percutaneous vertebroplasty were retrospectively analyzed.The patients were divided into an osteoporotic vertebral compression refracture group(n=39)and a control group(n=42)according to whether they had osteoporotic vertebral compression refracture after percutaneous vertebroplasty.General data,vertebral bone mineral density,paravertebral crosssectional area and mean CT value(Hu)of the two groups were analyzed.RESULTS AND CONCLUSION:(1)Univariate analysis showed that there was no significant difference in age and mean CT value of psoas major between the two groups(P>0.05).The body mass index,vertebral bone mineral density,paravertebral cross-sectional area and the mean CT value of the posterior vertebral muscle group in the control group were significantly higher than those in the osteoporotic vertebral compression refracture group(P<0.05).(2)Multivariate logistic regression analysis showed that low vertebral bone mineral density(OR=0.004,95%CI:0.000-0.555,P<0.05)and low mean CT value of posterior vertebral muscle group(OR=0.940,95%CI:0.894-0.988,P<0.05)were independent risk factors for postmenopausal osteoporotic vertebral compression refracture.(3)It is indicated that degeneration of paraspinal muscle will increase the risk of osteoporotic vertebral compression refractures in patients treated by percutaneous vertebroplas

关 键 词：骨质疏松性椎体压缩骨折 再骨折 椎旁肌 骨矿物密度 危险因素 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R445