3~18岁学生发生颈椎病的危险因素分析及颈椎活动度的年龄变化特点  

Analysis of risk factors for cervical spondylosis and the characteristics of the age change of cervical range of motion in students aged 3-18 years

作　　者：包木龙 王波[2] 丁岩 王海[4] BAO Mulong;WANG Bo;DING Yan;WANG Hai(The Fifth Department of Massage,the Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,Harbin,Heilongjiang 150001,China;Department of Orthopaedics,the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,Harbin,Heilongjiang 150001,China;Department of Rehabilitation,the Fifth Hospital of Harbin,Harbin,Heilongjiang 150001,China;Department of Pediatrics,the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,Harbin,Heilongjiang 150001,China)

机构地区：[1]黑龙江中医药大学附属第二医院推拿五科,黑龙江哈尔滨150001 [2]黑龙江中医药大学附属第一医院骨伤二科,黑龙江哈尔滨150001 [3]哈尔滨市第五医院康复科,黑龙江哈尔滨150001 [4]黑龙江中医药大学附属第一医院儿二科,黑龙江哈尔滨150001

出　　处：《检验医学与临床》2024年第13期1885-1889,共5页Laboratory Medicine and Clinic

基　　金：黑龙江省中医药管理局2023年度中医药科研课题(ZHY2023-021)。

摘　　要：目的分析3~18岁学生发生颈椎病的危险因素及颈椎活动度(CROM)的年龄变化特点,为该年龄段学生颈椎病的预防及诊断提供参考依据。方法选取2022年1-12月在黑龙江中医药大学附属第二医院及黑龙江中医药大学附属第一医院进行体检的915例3~18岁学生作为研究对象。设计调查问卷,对学生的年龄、性别、身高、体质量指数、每天体育锻炼时间、每天低头时间、每天使用电子产品时间、不良坐姿、不良睡姿、行走姿势不端正、颈部经常受凉等情况进行统计,检测所有学生CROM。采用颈椎功能障碍指数(NDI)评分评估颈椎病患儿的颈椎病严重程度。采用多因素Logistic回归分析3~18岁学生发生颈椎病的危险因素。绘制受试者工作特征(ROC)曲线分析CROM诊断颈椎病的效能。采用Pearson相关分析CORM与颈椎病严重程度的相关性。结果915例3~18岁学生中,诊断为颈椎病患儿237例,非颈椎病患儿678例。颈椎病组≥13岁的高年龄段、体质量指数>24 kg/m^(2)、每天体育锻炼时间<1 h、每天低头时间>8 h、不良坐姿、不良睡姿的患儿比例均高于非颈椎病组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,每天低头时间>8 h、不良坐姿、不良睡姿是3~18岁学生发生颈椎病的危险因素(P<0.05)。不同年龄段颈椎病学生颈椎前屈、后伸、左侧屈、右侧屈、左旋、右旋的活动度以及NDI评分比较,由低到高均分别为16~18岁、13~<16岁、6~<13岁、3~<6岁,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,CROM诊断颈椎病的曲线下面积为0.967,95%CI为0.953~0.977,约登指数为0.807,最佳截断值为≤48.37°,灵敏度为86.92%,特异度为93.81%。Pearson相关分析结果显示,CORM与NDI评分呈负相关(r=-0.537,P<0.05)。结论每天低头时间>8 h、不良坐姿、不良睡姿均为影响3~18岁学生发生颈椎病的危险因素,且随着颈椎病学生年龄段的增加Objective To analyze the risk factors of cervical spondylosis and the age change of cervical range of motion(CROM)in students aged 3-18 years,and to provide reference for the prevention and diagnosis of cervical spondylosis in this age group.Methods A total of 915 students aged 3-18 years who underwent physical examination in the Second Affiliated Hospital and the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from January 2022 to December 2022 were selected as the research objects.Design questionnaire,to student′s age,gender,height,body mass index,physical exercise time every day,every day down time,daily use electronic products,poor posture,bad sleeping posture,walk posture is not correct,the neck often catch cold catch cold,and so on and so forth,CROM detection of all students.Cervical disability Index(NDI)score was used to evaluate the severity of cervical spondylosis in children with cervical spondylosis.Multivariate Logistic regression was used to analyze the risk factors of cervical spondylosis in students aged 3-18 years.The receiver operating characteristic(ROC)curve was drawn to analyze the efficacy of CROM in the diagnosis of cervical spondylosis.Pearson correlation was used to analyze the correlation between CORM and the severity of cervical spondylosis.Results Among 915 students aged 3-18 years,237 were diagnosed as cervical spondylosis and 678 were non-cervical spondylosis.Cervical spondylosis group of 13 years old or more high age,body mass index>24 kg/m^(2),exercise time each day<1 h,bowed their heads and time every day>8 h,poor posture,bad sleeping posture group were higher than the proportion of the cervical spondylosis,differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that head bowed time>8 h per day,bad sitting posture and bad sleeping posture were the risk factors for cervical spondylosis in students aged 3-18 years(P<0.05).The ROM of cervical flexion,extension,left flexion,right flexion,left rotation an

关 键 词：不良坐姿 学生 颈椎病 危险因素 颈椎活动度 

分 类 号：R726.8[医药卫生—儿科]