中国骨质疏松杂志

女性椎体骨折患者骨密度与MRI椎旁肌肉参数的相关性研究

Correlation between bone mineral density and MRI paravertebral muscle parameters in female patients with vertebral fracture

DOI：10.3969/j.issn.1006-7108.2024.02.003

中文关键词: 骨质疏松症椎旁肌退变椎体骨折

英文关键词:osteoporosis paravertebral muscle degeneration vertebral fracture

基金项目:2021年广东省中医骨伤研究院开放课题重点项目(GYH202101-03)

作者	单位
田瀚1 钟业霖1 张银银1 郭海威2 李启活2 黄宏兴1 李颖1*	1．广州中医药大学，广东广州 510006 2．广州中医药大学第三附属医院，广东广州 510378

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中文摘要:

目的探讨女性椎体骨折患者骨密度与椎旁肌肉退变的相关性。方法回顾性选取2019年1月至2020年10月广州中医药大学第三附属医院龙溪院区脊柱科收治的86例椎体骨折女性患者进行横断面研究。根据年龄划分为＜75岁组、75~84岁组和≥85岁组，根据骨折节段的不同分为胸椎骨折组和腰椎骨折组。结果不同年龄组之间，L3多裂肌/竖脊肌、L3与L4脂肪浸润程度、L3脂肪厚度/腰椎压痕值呈相关性，差异具有统计学意义（P＜0.05）；椎体骨折患者的骨密度与L3~4腰椎肌肉程度呈正相关，与L3~4椎长/腰椎压痕值呈负相关，差异具有统计学意义（P＜0.05）；胸椎骨折组的骨密度与L3~4椎长/腰椎压痕值、L3脂肪厚度/腰椎压痕值、L4多裂肌/竖脊肌呈负相关。腰椎骨折组骨密度与L3腰椎肌肉程度、L3~4椎长/腰椎压痕值呈相关性，差异具有统计学意义（P＜0.05）。二元Logistic回归方程发现L4椎长/腰椎压痕值对胸腰椎的骨折节段影响具有统计学意义。以各参数为自变量进行逐步线性回归分析，得出因变量(骨密度)与自变量之间的回归方程为:骨密度指数= – 0.09′L3椎长/腰椎压痕值–1.15′L4多裂肌/竖脊肌–3.215。结论 L3和L4节段的腰椎肌肉程度、椎长/腰椎压痕值、多裂肌/竖脊肌、脂肪厚度/腰椎压痕值等参数是影响女性胸腰椎椎体骨折患者骨密度的因素。

英文摘要:

Objective To investigate the correlation between bone mineral density (BMD) and paravertebral muscle degeneration in female patients with vertebral fracture. Methods A cross-sectional study was conducted to retrospectively select the female patients with vertebral fractures admitted to the Department of Spine, Longxi Branch, the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from January 1, 2019 to October 31, 2020. Results L3 multifidus/erector spinae, L3 and L4 fat infiltration degree, L3 fat thickness/lumbar indentation value were correlated among different age groups, and the differences were statistically significant (P < 0.05). BMD of OVFs patients was positively correlated with L3 and L4 lumbar muscle degree, and negatively correlated with L3 and L4 vertebral length/lumbar indentation value, and the difference was statistically significant (P < 0.05). In the thoracic fracture group, BMD was negatively correlated with L3 and L4 vertebral length/lumbar indentation value, L3 fat thickness/lumbar indentation value, L4 multifidus/erector spinae. In the lumbar fracture group, BMD was correlated with L3 lumbar muscle degree and L3 and L4 vertebral length/lumbar indentation value, and the difference was statistically significant (P < 0.05).The binary Logistic regression equation found that the L4 vertebral length/lumbar indentation value thoracic had a statistically significant effect on the lumbar fracture segment. Stepwise linear regression analysis was performed with each parameter as the independent variable, and the regression equation between the dependent variable (bone mineral density) and the independent variable was obtained as follows: bone mineral density index = – 0.09′L3 vertebral length/lumbar indentation value – 1.15′L4 multifidus/erector spinae – 3.215. Conclusion Lumbar muscle degree, vertebral length/lumbar indentation value, multifidus/erector spinae, fat thickness/lumbar indentation value of L3 and L4 segments are the factors affecting female patients with thoracolumbar vertebral fractures.

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