股骨头血供参数和平均坏死面积指数与股骨头坏死ARCO分期的相关性分析  

Analysing the correlations of femoral head blood supply parameters and mean necrotic area index with ARCO stage of femoral head necrosis

作　　者：骆聪聪 董一平 袁强 张宁 尤若楠 张颖 LUO Congcong;DONG Yiping;YUAN Qiang;ZHANG Ning;YOU Ruonan;ZHANG Ying(Postgraduate College of Henan University of Chinese Medicine,Zhengzhou 450046,Henan,China;Postgraduate College of Hunan University of Chinese Medicine,Changsha 410208,Hunan,China;Luoyang Orthopedic-Traumatological Hospital,Luoyang 471002,Henan,China)

机构地区：[1]河南中医药大学研究生院,河南郑州450046 [2]湖南中医药大学研究生院,湖南长沙410208 [3]河南省洛阳正骨医院/河南省骨科医院,河南洛阳471002

出　　处：《中医正骨》2024年第9期36-39,48,共5页The Journal of Traditional Chinese Orthopedics and Traumatology

基　　金：国家自然科学基金项目(81774348)。

摘　　要：目的:分析股骨头血供参数和平均坏死面积指数与股骨头坏死国际骨微循环研究学会(Association Research Circulation Osseous,ARCO)分期的相关性,为量化评估股骨头血供和坏死程度提供参考。方法:纳入股骨头坏死患者60例(65髋),其中ARCOⅠ期11髋、Ⅱ期23髋、Ⅲ期16髋、Ⅳ期15髋。于患者股骨头血管造影片上测量并计算跨股骨颈的旋股内侧动脉长度与股骨颈直径的比值、后上支持带动脉数量、后下支持带动脉数量等股骨头血供参数,于股骨头轴位MRI T1加权像上测量并计算股骨头平均坏死面积指数。比较不同ARCO分期患髋的股骨头血供参数和平均坏死面积指数,采用Spearman相关分析法分析股骨头血供参数和平均坏死面积指数与股骨头坏死ARCO分期的相关性。结果:不同ARCO分期患髋的跨股骨颈的旋股内侧动脉长度与股骨颈直径的比值、后上支持带动脉数量、后下支持带动脉数量及股骨头平均坏死面积指数的组间差异均有统计学意义(H=16.191,P=0.001;H=31.331,P=0.000;H=13.737,P=0.003;H=12.699,P=0.005)。Spearman相关分析显示,跨股骨颈的旋股内侧动脉长度与股骨颈直径的比值、后上支持带动脉数量、后下支持带动脉数量与股骨头坏死ARCO分期均呈负相关(r_(s)=-0.489,P=0.000;r_(s)=-0.678,P=0.000;r_(s)=-0.456,P=0.000),股骨头平均坏死面积指数与股骨头坏死ARCO分期呈正相关(r_(s)=0.438,P=0.000)。结论:股骨头血供参数与股骨头坏死ARCO分期呈负相关,股骨头平均坏死面积指数与股骨头坏死ARCO分期呈正相关,这些指标对于量化评估股骨头血供和坏死程度具有一定的参考价值。Objective:To analyze the correlations of femoral head(FH)blood supply parameters and mean necrotic area index(MNAI)with Association Research Circulation Osseous(ARCO)stage of femoral head necrosis(FHN)so as to provide a reference for quantitatively assessing the blood supply and necrotic degree of FH.Methods:Sixty FHN patients(65 hips)were enrolled in the study,with 11 hips in ARCO stageⅠ,23 hips in stageⅡ,16 hips in stageⅢ,and 15 hips in stageⅣ.The FH blood supply parameters,including the ratio of the length of medial femoral circumflex artery(MFCA)across the femoral neck to the diameter of femoral neck,the numbers of posterior superior retinacular artery(SRA)and posterior inferior retinacular artery(IRA),were measured on the angiogram of FH and then calculated.Additionally,the MNAI of FH was measured on the axial MRI T1-weighted image of the FH and then calculated.Furthermore,the FH blood supply parameters and MNAI of the affected hips in the different ARCO stages were compared,and the correlations of FH blood supply parameters and MNAI with the ARCO stage of FHN were analyzed by using Spearman’s correlation analysis.Results:The differences were statistically significant in the ratio of the length of MFCA across the femoral neck to the diameter of femoral neck,the numbers of posterior SRA and IRA,MNAI among the hips in different ARCO stages(H=16.191,P=0.001;H=31.331,P=0.000;H=13.737,P=0.003;H=12.699,P=0.005).The results of Spearman correlation analysis revealed that the ratio of the length of MFCA across the femoral neck to the diameter of femoral neck,the numbers of posterior SRA and IRA were all negatively correlated with the ARCO stage of FHN(r_(s)=-0.489,P=0.000;r_(s)=-0.678,P=0.000;r_(s)=-0.456,P=0.000);while,the MNAI of FH was positively correlated with the ARCO stage of FHN(r_(s)=0.438,P=0.000).Conclusion:The FH blood supply parameters are negatively correlated with the ARCO stage of FHN;while,the MNAI is positively correlated with the ARCO stage of FHN.These indicators have a certain reference

关 键 词：股骨头坏死 股骨头血供 股骨头坏死面积 ARCO分期 

分 类 号：R681.8[医药卫生—骨科学]