老年骨质疏松症患者腰椎间盘突出症患病情况调查及影响因素分析  

Investigation on the prevalence and influencing factors of lumbar disc herniation in elderly patients with osteoporosis

作　　者：傅青 李巧平[1] 李璟[1] 郑佳蕾[1] 罗俏 丁晓婷 FU Qing;LI Qiaoping;LI Jing;ZHENG Jialei;LUO Qiao;DING Xiaoting(Department of Spinal Surgery,Lishui Central Hospital,Lishui 323000,China)

机构地区：[1]丽水市中心医院脊柱外科,丽水323000

出　　处：《中国临床保健杂志》2024年第4期543-546,共4页Chinese Journal of Clinical Healthcare

基　　金：浙江省丽水市科技计划项目(2022SJZC013)。

摘　　要：目的分析老年骨质疏松症患者并发腰椎间盘突出症(LDH)的患病情况及其影响因素。方法回顾性分析2020年5月至2023年10月间于丽水市中心医院进行腰椎定量计算机断层扫描(QCT)的528例老年患者病历资料。根据QCT骨密度值测量结果将患者分为骨质疏松症组(176例,骨密度值<80 mg/cm^(3))、低骨量组(192例,80 mg/cm^(3)≤骨密度值≤120 mg/cm^(3))和对照组(160例,骨密度值>120 mg/cm^(3))。根据3组患者病史及CT等结果,将骨质疏松症组患者分为LDH组和非LDH组,比较2组患者实验室指标、骨密度指标、腰腹肌耐力、营养状况等。采用logistic回归分析探究老年骨质疏松症患者并发LDH的影响因素。结果骨质疏松症组患者LDH患病率高于低骨量组和对照组,差异有统计学意义(P<0.05);LDH组雌二醇(E2)水平<18.35 pmol/L、骨密度<60 mg/cm^(3)及腰腹肌耐力<25 s的患者占比高于非LDH组(P<0.05);logistic回归分析结果显示:骨密度<60 mg/cm^(3)、E2水平<18.35 pmol/L及腰腹肌耐力<25 s为老年骨质疏松症患者并发LDH的独立危险因素(P<0.05);骨密度、E2及腰腹肌耐力预测老年骨质疏松症并发LDH的效能均较高(P<0.05)。结论老年骨质疏松症患者LDH患病率较普通人群及低骨量人群更高,且骨密度<60 mg/cm^(3)、E2水平越低、腰腹肌耐力<25 s的患者并发LDH的风险越高。Objective To analyze the prevalence status of lumbar disc herniation(LDH)in elderly patients with osteoporosis(OP)and to explore its influencing factors.Methods The medical records of 528 elderly patients who underwent lumbar quantitative computed tomography(QCT)at Lishui Central Hospital from May 2020 to October 2023 were analyzed retrospectively.According to the measurement results of QCT bone mineral density,the patients were divided into osteoporosis group(n=176,bone mineral density<80 mg/cm^(3)),low bone mass group(n=192,80≤bone mineral density≤120 mg/cm^(3))and control group(n=160,bone mineral density>120 mg/cm^(3)).The general data were collected among the three groups,and the medical history and results of X-ray,CT and other imaging examinations were comprehensively evaluated,and the prevalence status of LDH was determined.According to the presence or absence of prevalence of LDH,the patients in the osteoporosis group were divided into LDH group and non-LDH group.The general data,laboratory indicators,bone mineral density indicators,lumbar and abdominal muscle endurance and nutritional status were compared between both groups.Logistic regression analysis was used to explore the influencing factors of LDH in elderly patients with OP.Results The prevalence rate of LDH in osteoporosis group was significantly higher than that in low bone mass group and control group(P<0.05).Univariate analysis showed that the proportions of estradiol(E2)level<18.35 pmol/L,bone mineral density<60 mg/cm^(3)and lumbar and abdominal muscle endurance<25 s in LDH group were higher than those in non-LDH group(P<0.05).Multivariate analysis revealed that bone mineral density<60 mg/cm^(3),E2 level<18.35 pmol/L and lumbar and abdominal muscle endurance<25 s were independent risk factors for LDH in elderly patients with OP(P<0.05).Bone mineral density,E2 and lumbar and abdominal muscle endurance had high efficiency on predicting LDH in elderly OP patients(P<0.05).Conclusions The prevalence rate of LDH in elderly patients with osteopo

关 键 词：骨质疏松 椎间盘移位 患病率 危险因素 老年人 

分 类 号：R580[医药卫生—内分泌] R681.5[医药卫生—内科学]