多排螺旋CT在腰部肌群形态学参数与临床症状严重程度的关系  

Relationship between Multi-slice Spiral CT Measurements of Morphological Parameters of Lumbar Muscle Group and the Severity of Clinical Symptoms

作　　者：吴茂明 王俊华[1] WU Mao-ming;WANG Jun-hua(The Fifth Clinical School of Medicine,Guangzhou University of Chinese Medicine,Guangzhou 510000,Guangdong Province,China;Maoming Hospital of Traditional Chinese Medicine,Maoming 525000,Guangdong Province,China)

机构地区：[1]广州中医药大学第五临床医学院,广东广州510000 [2]茂名市中医院,广东茂名525000

出　　处：《中国CT和MRI杂志》2024年第8期132-134,共3页Chinese Journal of CT and MRI

基　　金：广东省中医药局科研课题(20221198)。

摘　　要：目的分析多排螺旋CT在腰部肌群形态学参数与临床症状严重程度的关系。方法选取本院2015年1月~2023年12月收治的60例下腰痛症状患者,所有患者均接受多排螺旋CT扫描,于患者L3椎体最长横突水平测定腰大肌、腰方肌、竖脊肌的横断面积以及CT值;观察组患者接受日本骨科协会评估治疗指数(JOA)评估,其中患者依据JOA评分分为轻度组、中度组和重度组。比较不同临床症状严重程度的患者一般资料及腰部肌群形态学参数。结果依据JOA评分,评分在17~23分之间27患者纳入为轻度组,评分在8~17分的20例患者纳入为中度组,评分≤8分的13例患者纳入为重度组。不同临床症状严重程度患者临床资料比较差异无统计学意义(P>0.05),但不同临床症状严重程度患者腰大肌、腰方肌、竖脊肌的横断面积及CT值均存在差异(P>0.05);Spearman相关性分析显示,腰大肌、腰方肌、竖脊肌的横断面积、CT值与临床症状严重程度呈显著负相关(P<0.05);经多因素Logistic回归分析结果显示,腰大肌、腰方肌、竖脊肌的横断面积、CT值为临床症状严重程度的影响因素(P<0.05)。结论多排螺旋CT下的腰部肌群形态学参数与腰痛患者症状严重程度存在明显相关性。Objective To analyze the relationship between multi-slice spiral CT measurements of morphological parameters of lumbar muscle group and the severity of clinical symptoms.Methods Sixty patients with low back pain symptoms who were admitted to the hospital from January 2015 to December 2023 were enrolled in this study.All patients underwent multi-slice spiral CT scan.The cross-sectional areas and CT values of the psoas major,quadratus lumborum and erector spinae were measured at the longest transverse process level of L3 vertebral body.According to Japan Orthopedic Association(JOA)score,the patients were divided into mild group,moderate group and severe group.Clinical data and morphological parameters of lumbar muscle group of patients with different severity of clinical symptoms were comparatively analyzed.Results According to JOA score,27 patients with scores between 17 and 23 were included in the mild group,20 patients with scores between 8 and 17 were included in the moderate group,and 13 patients with scores≤8 were included in the severe group.There was no statistically significant difference in clinical data among patients with different severity of clinical symptoms(P>0.05).The cross-sectional areas and CT values of the psoas major,quadratus lumborum and erector spinae in patients with different severity of clinical symptoms were significantly different(P>0.05).Spearman correlation analysis found that cross-sectional areas and CT values of the psoas major,quadratus lumborum and erector spinae were negatively correlated with the severity of clinical symptoms(P<0.05).Multivariate logistic regression analysis results showed that cross-sectional areas and CT values of the psoas major,quadratus lumborum and erector spinae were factors influencing the severity of clinical symptoms(P<0.05).Conclusion There is a significant correlation between multi-slice spiral CT measurements of morphological parameters of lumbar muscle group and the severity of clinical symptoms in patients with low back pain.

关 键 词：下腰痛 临床症状严重程度 多排螺旋CT 腰部肌群形态学参数 日本骨科协会评估治疗指数 

分 类 号：R323.3[医药卫生—人体解剖和组织胚胎学]