OVCF患者椎旁肌密度与椎体骨密度的相关性研究  

Association of Paravertebral Muscle Density with Vertebral Bone Mineral Density in OVCF Patients

作　　者：侯俊俊 侯福山 车艳军 张连迂 陈琪 钱宗娜 沈佳莉 刘华清 司卫兵 郝跃峰[4] 杨晶[1] Hou JunJun;Hou Fushan;CheYanjun;Zhang Lianyu;Chen Qi;Qian Zongna;Shen Jiali;Liu Huaqing;Si Weibing;Hao Yuefeng;Yang Jing(The First Affiliated Hospital of Soochow University,Suzhou 215006,China;Xinghu Hospital,Suzhou Industrial Park,Suzhou 215000,China;The Second Hospital of Shanxi Medical University,Taiyuan 030001,China;The Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou 215008,China;Health Supervision Institute of Gusu District,Suzhou 215000,China)

机构地区：[1]苏州大学附属第一医院,江苏苏州215006 [2]苏州工业园区星湖医院,江苏苏州215000 [3]山西医科大学第二医院,山西太原030001 [4]南京医科大学附属苏州医院,江苏苏州215000 [5]苏州市姑苏区卫生监督所,江苏苏州215000

出　　处：《实用骨科杂志》2024年第7期594-599,631,共7页Journal of Practical Orthopaedics

基　　金：江苏省双创人才计划项目(JSSCBS20211588);苏州市姑苏卫生人才计划科研项目(GSWS2021035);苏州市卫生健康委员会科技项目(DZXYJ202307);苏州市科技发展计划(医疗卫生科技创新)项目(SKY2022185);苏州市中西医结合科研基金项目(SKYD2023254);南京医科大学姑苏学院临床研究项目(GSKY20240208,GSKY20230402)。

摘　　要：目的探讨骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)患者腰骶区椎旁肌密度与椎体骨密度(vertebral bone mineral density,vBMD)之间的关系。方法回顾性分析了OVCF患者的前瞻性机构数据库(NCT05848167)。纳入2021年1月至2022年12月共167例患者资料,其中101例定量CT(quantitative computed tomography,QCT)检查资料可用的OVCF患者,女80例,男21例;女性中位年龄73(68.00,82.50)岁,男性中位年龄71(67.00,80.00)岁。在L_(3~5)椎体上终板水平进行椎旁肌密度和面积测量,并使用人工分割和定制编写的程序进行计算。利用QCT Pro软件在L_(1~2)水平进行vBMD测量和计算。按性别、年龄对所有分析进行分层分析。结果本研究发现男性患者的椎旁肌密度与vBMD有统计学相关。在调整年龄和性别后,L_(1~2)vBMD与L_(3)左侧多裂肌、L_(4)左侧竖脊肌、L_(4)右侧多裂肌、L_(5)左右双侧多裂肌密度之间存在统计学意义上的正相关,而在女性患者中未发现显著相关性。结论男性多裂肌密度和vBMD在不同的腰椎水平存在显著的正相关,这与年龄无关。在解释腰椎椎体和椎旁肌关联时,应考虑性别及区域性差异。Objective To investigated the correlation between paravertebral muscle density in the lumbosacral region and vertebral bone mineral density(vBMD)as assessed by site-specific quantitative computed tomography(QCT)in patients suffering from osteoporotic vertebral compression fracture(OVCF).Methods This study performed a retrospective analysis of a prospective institutional database(NCT05848167),enrolling patients with osteoporotic spinal fractures.From January 2021 to December 2022,a total of 167 patients were included,among which 101 patients with OVCF[(80 females and 21 males,with a mean age of 73(68.00,82.50)years for females and 71(67.00,80.00)years for males)]possessed available examination data,specifically QCT data.Measurements of the posterior paraspinal muscle(PSM)density and area were undertaken at the superior endplate level of the L_(3~5)vertebral bodies,employing both manual segmentation and custom-developed software.Furthermore,measurements and calculations of vBMD were executed at the L^(1~2)level using QCT Pro software.All assessments were analyzed with stratification by sex and age.Results The analysis revealed a statistically significant correlation between PSM density and vBMD specifically within the male subject cohort.Upon implementing age and sex-specific stratification,a positive statistical association emerged between L_(1~2)vBMD and the density of multiple posterior paraspinal muscles,including the L_(3)left multifidus,L_(4)left erector spinae,L_(4)right multifidus,and both the L_(5)left and right bilateral multifidus muscles.In contrast,no significant correlation was detected in the female subject cohort.Conclusion The investigation demonstrated a pronounced positive correlation between multifidus muscle density and vBMD across various lumbar vertebral levels specifically in males.Notably,it underscores the importance of accounting for sexual dimorphism and regional variations when elucidating the intricate relationships between lumbar vertebrae and the posterior paraspinal muscles.

关 键 词：椎旁肌密度 骨质疏松症 肌少症 骨质疏松性椎体压缩骨折 定量CT 

分 类 号：R681.5[医药卫生—骨科学]