腰痛患者椎体Modic改变与骨质疏松的相关性研究  

Correlation between Modic changes of vertebral body and osteoporosis in patients with low back pain

作　　者：曹威[1] 惠正广[1] 夏梦娇 李朝顶[1] 张磊[1] CAO Wei;HUI Zhengguang;XIA Mengjiao;LI Chaoding;ZHANG Lei(Department of Orthopaedics,Xuzhou City Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Xuzhou 221000,Jiangsu,China)

机构地区：[1]南京中医药大学附属徐州市中医院骨伤科,江苏徐州221000

出　　处：《中国现代医生》2025年第12期49-52,共4页China Modern Doctor

摘　　要：目的研究腰痛患者腰骶椎Modic改变(Modic changes,MCs)及其类型与骨质疏松的关系。方法选取2021年1月至2024年9月于南京中医药大学附属徐州市中医院就诊的女性腰痛患者204例为研究对象,根据磁共振成像结果将患者分为MCs组(139例)和无MCs组(65例),将MCs组按MCs分型分为Ⅰ型组(33例)、Ⅱ型组(90例)和Ⅲ型组(16例)。比较各组患者的年龄、髋部骨密度(bone mineral density,BMD)及其T值。结果MCs组和无MCs组患者的年龄、髋部BMD及相应T值比较差异均无统计学意义(P>0.05)。四组患者的髋部BMD及相应T值依次为Ⅲ型组>无MCs组>Ⅱ型组>Ⅰ型组。Ⅲ型组患者骨量多处于正常水平,其余三组患者多处于骨量减少或骨质疏松水平。Ⅱ型组与无MCs组患者的髋部BMD及相应T值比较差异均无统计学意义(P>0.05),Ⅲ型组患者的髋部BMD及相应T值均显著高于其余三组(P<0.05)。Ⅰ型组患者的髋部BMD及相应T值均显著低于其余三组(P<0.05)。结论腰痛患者不同的骨量水平有不同的MCs发病倾向:较高骨量(骨量正常)者多发生Ⅲ型MCs,骨量减少或骨质疏松者则易发Ⅰ型MCs,应重视Ⅰ型MCs患者的抗骨质疏松治疗。Objective To investigate the relationship between lumbosacral Modic changes(MCs)and their types and osteoporosis in patients with low back pain.Methods A total of 204 female patients with low back pain who were treated in Xuzhou City Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine from January 2021 to September 2024 were selected as study objects.According to magnetic resonance imaging results,the patients were divided into MCs group(139 cases)and non-MCs group(65 cases).MCs group was divided into typeⅠgroup(33 cases),typeⅡgroup(90 cases)and typeⅢgroup(16 cases)according to MCs type.The age,hip bone mineral density(BMD)and T value of all groups were compared.Results There was no significant difference in age,hip BMD and T value between MCs group and non-MCs group(P>0.05).Hip BMD and T values of four groups were typeⅢgroup>non-MCs group>typeⅡgroup>typeⅠgroup.Most of patients in typeⅢgroup had normal bone mass,and most of patients in other three groups had decreased bone mass or osteoporosis.There was no significant difference in hip BMD and T value between typeⅡgroup and non-MCs group(P>0.05).The hip BMD and corresponding T values of patients in groupⅢsignificantly higher than the other three groups(P<0.05).The hip BMD and corresponding T values of typeⅠpatients were significantly lower than those of the other three groups(P<0.05).Conclusion Patients with low back pain have different tendency of MCs with different bone mass.High bone mass(normal bone mass)is more likely to develop typeⅢMCs,and low bone mass or osteoporosis is more likely to develop typeⅠMCs.Anti-osteoporosis therapy for patients with typeⅠMCs should be emphasized.

关 键 词：腰痛 MODIC改变 骨密度 

分 类 号：R681.5[医药卫生—骨科学]