摘要
目的研究定量CT骨密度(QCT-BMD)对骨质疏松性椎体压缩骨折(OVCFs)患者经皮椎体成形术(PVP)后椎体压缩骨折复发的预测价值。方法回顾性分析PVP手术治疗的OVCFs患者108例(骨折复发组15例,骨折未复发组93例)。比较两组患者年龄、性别、体重指数(BMI)、病程、伤椎上位、下位椎体QCT-BMD、骨水泥注入量、骨水泥渗漏。采用logistic回归筛选PVP术后骨折复发独立危险因素。AUC分析QCT-BMD对骨折复发预测准确性。Kaplan-Meier生存分析、Cox比例风险回归模型分析QCT-BMD对3年椎体压缩骨折复发的预测价值。结果骨折复发组伤椎上位和下位椎体QCT-BMD均明显低于骨折未复发组(P<0.01)。上位椎体QCT-BMD是PVP术后患者骨折复发的独立预测因素(OR=0.945,P=0.006)。AUC为0.802,特异度为100.0%,敏感度为59.3%。上位椎体QCT-BMD≤59.15 mg Ca-HA/mL患者3年骨折复发风险明显升高(P=0.002)。风险比(HR)为0.951(95%CI 0.916~0.987,P=0.008)。结论QCT-BMD值对于PVP术后患者骨折复发具有早期预测价值。
Objective To study the predictive value of quantitative CT bone mineral density(QCT-BMD)on the recurrent vertebral compression fractures after percutaneous vertebroplasty(PVP)in patients with osteoporotic vertebral compression fractures(OVCFs).Methods A total of 108 patients of OVCFs treated with PVP were retrospectively analyzed(15 cases in the fracture recurrence group and 93 cases in the fracture non-recurrence group).The age,sex,body mass index(BMI),course of disease,BMD of upper and lower vertebral bodies determined by QCT,bone cement injection and bone cement penetration were compared between the two groups.The logistic regression were used to screen the independent risk factors of recurrent fracture after PVP surgery in patients with OVCFs.The Area Under Curve(AUC)analysis of was used to evaluate the predictive efficacy of QCT-BMD on recurrent fracture.The Kaplan-Meier survival analysis and Cox proportional hazards regression model were used to analyze the predictive value of QCT-BMD for recurrent vertebral compression fractures in three years.Results The QCT-BMD of the upper and lower vertebrae in the fracture recurrence group was significantly lower than that in the fracture non-recurrence group(P<0.01).QCT-BMD of upper vertebral(OR=0.945,P=0.006)was an independent predictor of fracture recurrence in patients after PVP.AUC was 0.802,specificity was 100.0%,sensitivity was 59.3%.The risk of fracture recurrence in patients with QCT-BMD less than 59.15 mg Ca-HA/mL of upper vertebral in three years was significantly higher(P=0.002).HR was 0.951(95%CI 0.916-0.987,P=0.008).Conclusion QCT-BMD has early predictive value for fracture recurrence in patients with OVCFs after PVP.
作者
王长松
曾宪发
肖红丽
WANG Changsong;ZENG Xianfa;XIAO Hongli(Department of orthopedics,Jingdong Yumei Integrated Traditional Chinese and Western Medicine Kidney Disease Hospital,Langfang,Hebei 065201,China;Department of Emergency Medicine,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)
出处
《现代医药卫生》
2023年第5期741-746,共6页
Journal of Modern Medicine & Health
基金
北京市医院管理局青年人才培养“青苗”计划(QML20170105)
廊坊市科技支撑计划项目(2014013144)。
关键词
骨质疏松性椎体压缩骨折
经皮椎体成形术
骨折复发
定量CT
骨密度
Osteoporotic vertebral compression fracture
Percutaneous vertebroplasty
Fracture recurrence
Quantitative computed tomography
Bone density
