骨质疏松性椎体压缩骨折行非手术治疗后早期生活质量改善的相关预测因素  

Predictors of early quality of life improvement after non-surgical treatment of osteoporotic vertebral compression fractures

作　　者：张建锋[1] 张良 张士杰[1] ZHANG Jian-feng;ZHANG Liang;ZHANG Shi-jie(Puyang People’s Hospital,Puyang,Henan 457000,China)

机构地区：[1]河南省濮阳市人民医院,河南濮阳457000

出　　处：《颈腰痛杂志》2023年第4期563-566,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)患者行保守治疗后早期生活质量改善情况的相关预测因素。方法对2018年1月~2020年1月在本院接受非手术治疗的166例OVCF患者进行分析,观察其随访48周时的欧洲五维生存质量评分(European quality of life-5 dimensions,EQ-5D)改善情况,统计患者入院时的相关因素并进行统计学单因素分析与多因素回归分析,验证患者早期生活质量改善的相关预测因素。结果与入院时相比,患者VAS评分在随访12周、48周时均明显下降(P<0.01),EQ-5D评分均显著升高(P<0.01);随访48周时,MRI检查显示骨不连28例,邻椎继发性骨折10例。单因素分析显示,年龄(P=0.04)、骨折至就诊时间(P=0.03)、入院时VAS评分(P=0.02)、入院时EQ-5D评分(P<0.001)、入院时T1弥漫性低信号(P=0.01)和T2局限性高信号(P<0.01),均与EQ-5D评分改善程度存在潜在的相关性。多因素回归分析显示:入院时EQ-5D评分(P<0.001)、入院时VAS评分(P<0.001)、年龄(P=0.03)、入院时T2局限性高信号(P=0.04),均是OVCF患者行非手术治疗后EQ-5D评分改善程度的独立预测因素(P<0.05)。据此得出预测方程:EQ-5D评分的改善程度=1.305-0.978×入院时EQ-5D评分-0.021×入院时VAS评分-0.006×年龄+(入院时T2局限性高信号:-0.037,非T2局限性高信号:+0.037);R^(2)=0.71。结论入院时EQ-5D评分、VAS评分、年龄和MRI表现是OVCF患者行非手术治疗后早期生活质量改善的独立预测因素;VAS评分偏高、T2局限性高信号和高龄人群应警惕其生活质量改善不佳的风险。Objective To investigate the predictors of early quality of life improvement in patients with osteoporotic vertebral compression fracture(OVCF)after conservative treatment.Methods The clinical data of 166 patients with OVCF who receivednon-surgical treatmentin our hospital from January 2018 to January 2020 were analyzed.The improvement of European quality of life-5 dimensions(EQ-5D)at 48 weeks of follow-up was observed.The relevant factors at admission were counted,and statistical univariate analysis and multivariate regression analysis were carried outto verify the relevant predictors of early quality of life improvement.Results Compared with admission,the average VAS score of all patients decreased significantly at 12 and 48 weeks of follow-up(P<0.01),and the EQ-5D score increased significantly(P<0.01);At 48 weeks of follow-up,28 cases of nonunion and 10 cases of secondary fracture of adjacent vertebrae were found by MRI.Univariate analysis showed that age(P=0.04),time from fracture to visit(P=0.03),VAS score at admission(P=0.02),EQ-5D score at admission(P<0.001),T1 diffuse low signal(P=0.01)and T2 localized high signal(P<0.01)were potentially correlated with the improvement of EQ-5D score.Multivariate regression analysis showed that EQ-5D score at admission(P<0.001),VAS score at admission(P<0.001),age(P=0.03)and T2 localized high signal at admission(P=0.04)were independent predictors of the improvement of EQ-5D score after non-surgical treatment in OVCF patients(P<0.05).According to this,the prediction equation was obtained:the improvement degree of EQ-5D score=1.305-0.978×EQ-5D score at admission-0.021×VAS score at admission-0.006×Age+(T2 localized hyperintensity at admission:0.037,non T2 localized hyperintensity:+0.037);R^(2)=0.71.Conclusion EQ-5D score,VAS score,age and MRI performance at admission are independent predictors of early improvement of quality of life in OVCF patients after non-surgical treatment.High VAS score,T2 localized high signal and elderly people should be alert to the risk of poor i

关 键 词：骨质疏松症 压缩性椎体骨折 老年 非手术治疗 生活质量 

分 类 号：R683.2[医药卫生—骨科学]