基于定量CT分析维持性血液透析患者腰椎骨密度与体质成分的相关性  

Correlation analysis of lumbar bone mineral density and body composition in maintenance hemodialysispatients based on quantitative CT

作　　者：吕磊 翟建[1] 李培[1] 刘奇峰 方世武 LYU Lei;ZHAI Jian;LI Pei(Medical Imaging Center,Yijishan Hospital of Wannan Medical College,Wuhu 241001,China)

机构地区：[1]皖南医学院弋矶山医院影像中心,安徽芜湖241001

出　　处：《放射学实践》2024年第2期247-252,共6页Radiologic Practice

摘　　要：目的:采用定量CT技术(QCT),分析维持性血液透析(MHD)患者的腰椎骨密度(BMD)与体成分及其他相关指标的关系。方法:回顾性分析弋矶山医院2014年7月-2022年8月维持性血液透析患者共106例,使用QCT测量患者的L1、L2的BMD,L3中心层面的体成分信息,包括内脏脂肪(VAT)、皮下脂肪(SAT)、总脂肪(TAT)、腰3水平横断面肌肉面积(L3-SMA),腰3水平肌肉内的脂肪含量(L3-IMAT),同时记录患者的年龄、性别、透析时长及血液生化指标,采用Pearson相关分析MHD患者腰椎BMD与各指标的相关性。依据BMD测量结果,将106例MHD患者分为骨量正常组(n=61)及骨量异常组(n=45),比较两组间体成分及各个临床指标的差异,并采用多因素logistic回归分析MHD患者骨量异常的危险因素。结果:106名MHD患者中57.55%(61例)骨量正常,42.45%(45例)骨量异常,其中26.41%(28例)骨量减少,16.04%(17例)骨质疏松。骨量异常组的年龄、TC、LDL-C、P、VAT、SAT、TAT、L3-SMA及L3-IMAT均高于骨量正常组,差异具有统计学意义(P<0.05),两组间的性别、透析龄、TG、HDL-C、ALB及Ca水平差异无统计学意义(P>0.05)。MHD患者腰椎BMD与L3-SMA呈正相关(r=0.264,P<0.05),与年龄、VAT、SAT、TAT、L3-IMAT及TC呈负相关(P<0.05)。未发现MHD患者腰椎BMD与透析龄、TG、HDL-C、LDL-C、ALB、Ca及P存在相关性(P>0.05),多因素logistic回归显示高血磷、高龄及高L3-IMAT是MHD患者发生骨量异常的危险因素。结论:MHD患者腰椎BMD与体成分、年龄及TC有相关性,高血磷、高龄及高L3-IMAT是MHD患者发生骨量异常的独立危险因素。Objective:To analyze the correlation between lumbar bone mineral density(BMD)and body composition and other related indexes in maintenance hemodialysis(MHD)patients by quantitative computed tomography(QCT)technique.Methods:A total of 106 patients with maintenance hemodialysis in Yijishan Hospital from July 2014 to August 2022 were retrospectively analyzed.QCT was used to measure the BMD of L1 and L2,and the body composition information of L3 central level,including visceral adipose tissue(VAT),subcutaneous adipose tissue(SAT),total adipose tissue(TAT),L3-skeletal muscle area(L3-SMA),and L3-intramuscular fat(L3-IMAT).At the same time,the age,gender,dialysis duration and blood biochemical indicators of the patients were recorded.Pearson correlation analysis was used to analyze the correlation between lumbar BMD and various indicators in MHD patients.According to the results of BMD measurement,106 MHD patients were divided into normal bone mass group(n=61)and abnormal bone mass group(n=45).The differences in body composition and various clinical indicators between the two groups were compared,and multivariate logistic regression was used to analyze the risk factors of abnormal bone mass in MHD patients.Results:Among the 106 patients with MHD,57.55%(61 cases)had normal bone mass and 42.45%(45 cases)had abnormal bone mass,including 26.41%(28 cases)with reduced bone mass and 16.04%(17 cases)with osteoporosis.The age,total cholesterol(TC),LDL-C,Phosphorus(P),VAT,SAT,TAT,L3-SMA and L3-IMAT in the abnormal bone mass group were higher than those in the normal bone mass group and the difference was statistically significant(P<0.05).The differences in gender,dialysis age,triglyceride(TG),HDL-C,ALB and Ca levels between the two groups were not statistically significant(P>0.05).Lumbar BMD in MHD patients was positively correlated with L3-SMA(r=0.264,P<0.05),and negatively correlated with age,VAT,SAT,TAT,L3-IMAT and TC(P<0.05).No correlation was found between lumbar BMD and dialysis age,TG,HDL-C,LDL-C,ALB,Ca and P in MHD patien

关 键 词：体层摄影术 X线计算机 体质 骨密度 肾透析 

分 类 号：R814.4[医药卫生—影像医学与核医学] R33[医药卫生—放射医学] R336[医药卫生—临床医学] R459.5