基于L3层面躯干肌质量与腰椎小关节骨性关节炎严重程度的相关性  

Correlation Between L3 Level Trunk Muscle Mass and Severity of Lumbar Facet Joint Osteoarthritis

作　　者：周兴顺 罗军德 张巧玲 端木羊羊 张雯双 耿健 王玲 程晓光 ZHOU Xingshun;LUO Junde;ZHANG Qiaoling;DUANMU Yangyang;ZHANG Wenshuang;GENG Jian;WANG Ling;CHENG Xiaoguang(National Center for Orthopedics,Department of Radiology,Beijing Jishuitan Hospital,Capital Medical University,Beijing Research Institute of Traumatology and Orthopaedics,Beijing 100035,China;不详)

机构地区：[1]中国人民解放军联勤保障部队第九二六医院,云南开远661600 [2]国家骨科医学中心、首都医科大学附属北京积水潭医院,北京市创伤骨科研究所,北京100035

出　　处：《中国医学影像学杂志》2024年第12期1272-1276,共5页Chinese Journal of Medical Imaging

基　　金：北京市医院管理中心临床医学发展专项(ZYLX202107)。

摘　　要：目的 探讨中老年人群中,L3层面躯干肌质量与腰椎小关节骨性关节炎(FJOA)严重程度的相关性。资料与方法 采用OsiriX图像处理软件对2016年3—6月北京积水潭医院312例44~82岁个体进行分析,测定其L3椎体下终板层面躯干肌总面积和CT值,计算骨骼肌指数。根据Weishaupt椎小关节骨性关节炎分级标准,测定L4~5双侧椎小关节骨性关节炎的程度。比较不同性别L3下终板层面躯干肌CT值、L3下终板层面躯干肌面积、骨骼肌指数、体重指数、年龄以及L4~5左、右侧FJOA分级的差异。分析L3下终板层面躯干肌CT值与FJOA分级的相关性。结果 109例男性躯干肌均值与L4~5左、右侧FJOA分级呈负相关(r=0.25,P=0.002;r=0.28,P=0.003),年龄与L4~5左、右侧FJOA分级呈正相关(r=0.23,P=0.034;r=0.21,P=0.033)。203例女性躯干肌均值与L4~5左、右侧FJOA分级呈负相关(r=0.29,P<0.001;r=0.33,P<0.001),年龄与L4~5左、右侧FJOA分级呈正相关(r=0.27,P<0.001;r=0.34,P<0.001),体重指数与L4~5左、右侧FJOA分级呈正相关(r=0.20,P=0.018;r=0.23,P=0.004)。在控制年龄因素的情况下,偏相关分析显示男性和女性L4~5双侧FJOA分级的严重程度与L3躯干肌均值呈一定负相关(r=0.239、 0.249、 0.177、 0.169,P<0.05)。结论 L3层面躯干肌质量与FJOA严重程度呈一定负相关,而FJOA作为慢性腰痛的独立因素之一,加强营养摄入及体育锻炼,有利于预防肌肉减少症的发生、发展,从而减少FJOA的发生及加重,进而减少慢性腰痛患者的负担。Purpose To investigate the correlation between lumbar trunk muscle mass at the L3 level and the severity of lumbar facet joint osteoarthritis(FJOA)in the middle-aged and elderly population.Materials and Methods The analysis involved 312 individuals aged between 44 and 82 years in Beijing Jishuitan Hospital from March to June 2016.The total area and CT values of the lumbar trunk muscles at the L3 vertebral body's lower endplate level were measured to calculate the skeletal muscle mass index via OsiriX image processing software.Furthermore,the severity of bilateral lumbar facet osteoarthritis at the L4-5 level was assessed using the Weishaupt grading criteria.CT value of trunk muscle at L3 lower endplate level,trunk muscle area at L3 lower endplate level,skeletal muscle index,body mass index,age and FJOA grade at L4-5 right and left sides were compared between genders.The correlation between the mean value of trunk muscle CT and FJOA grade at the lower endplate level of L3 was analyzed.Results In 109 male patients,the mean trunk muscle was negatively correlated with FJOA grade on the right and left sides of L4-5(r=-0.25,P=0.002;r=-0.28,P=0.003),while age was positively correlated with FJOA grade on the right and left sides of L4-5(r=0.23,P=0.034;r=0.21,P=0.033).In 203 female patients,there was a negative correlation between trunk muscle mean and both right and left FJOA grade at L4-5(r=-0.29,P<0.001;r=-0.33,P<0.001),there was a positive correlation between age and both right and left FJOA grade at L4-5(r=0.27,P<0.001;r=0.34,P<0.001),and there was a positive correlation between body mass index and both right and left FJOA grade at L4-5(r=0.20,P=0.018;r=0.23,P=0.004).Partial correlation analysis,controlling for age,showed that the severity of bilateral FJOA at L4-5 was somewhat negatively correlated with the mean value of the L3 trunk muscle in the male and female groups(r=-0.239,-0.249,-0.177,-0.169,all P<0.05).Conclusion Trunk muscle mass at the L3 level is negatively correlated with the severity of FJOA,and FJOA i

关 键 词：肌肉衰减征 椎小关节骨性关节炎 体层摄影术 X线计算机 躯干肌 相关性 

分 类 号：R445.3[医药卫生—影像医学与核医学] R684.3[医药卫生—诊断学]