更年期慢性下腰痛女性椎体骨密度与Modic改变的相关性

发布时间：2018-08-21 14:44

【摘要】：目的既往文献报道女性Modic改变的发生率高于男性,推测可能与更年期女性体内激素水平改变导致骨质疏松等因素有关。本文对更年期慢性下腰痛女性椎体骨密度与腰椎MRI上Modic改变的相关性进行研究,探讨椎体骨密度在Modic改变中的意义。资料与方法选择慢性下腰痛更年期女性205例,行椎体骨密度测定及腰椎MRI检查,测定椎体骨量并观察影像学资料。将所有患者根据其骨量水平分为骨量正常组(128例)、骨量减少组(58例)及骨质疏松组(19例)。比较3组Modic改变的发生率,分析椎体骨密度与Modic改变的关系。结果 205例患者中,骨量正常128例,Modic改变44例(I型19例,II型22例,III型3例),发生率为34.4%;骨量减少58例,Modic改变34例(I型15例,II型17例,III型2例),发生率为58.6%;骨质疏松19例,Modic改变15例(I型6例,II型7例,III型2例),发生率为78.9%。3组间Modic改变发生率差异有统计学意义(χ2=18.995,P0.05)。Pearson列联系数C=0.290.40。骨量减少组、骨质疏松组Modic改变发生率均高于骨量正常组(χ2=9.636、13.680,P0.01),骨量减少组与骨质疏松组间Modic改变发生率比较差异无统计学意义(χ2=2.555,P0.05)。结论更年期慢性下腰痛女性椎体骨密度与Modic改变有相关性。Modic改变的发生率随着椎体骨密度的减低而升高,但其关联性较弱,Modic改变的发生是一个动态发展的过程,除椎体骨密度外还受其他因素的影响。
[Abstract]:Objective Previous literatures reported that the incidence of Modic changes in women was higher than that in men, presumably related to factors such as osteoporosis caused by hormone changes in menopausal women. Materials and Methods 205 climacteric women with chronic low back pain were selected for vertebral bone mineral density measurement and lumbar MRI. The vertebral bone mass was measured and the imaging data were observed. All patients were divided into normal bone mass group (128 cases), osteopenia group (58 cases) and osteoporosis group (19 cases). Results Among 205 cases, 128 cases had normal bone mass, 44 cases had Modic changes (type I 19 cases, type II 22 cases, type III 3 cases), the incidence was 34.4%; 58 cases had bone loss, 34 cases had Modic changes (type I 15 cases, type II 17 cases, type III 2 cases), the incidence was 58.6%; 19 cases had osteoporosis, 15 cases had Modic changes (type I 6 cases, type II 7 cases, type II 7 cases, type III 2 cases). The incidence of Modic changes in osteoporosis group was higher than that in normal bone mass group (_2 = 9.636, 13.680, P 0.01). There was a significant difference in the incidence of Modic changes between osteoporosis group and osteoporosis group (_2 = 18.995, P 0.05). There was no significant difference (_2 = 2.555, P 0.05). Conclusion There was a correlation between vertebral BMD and Modic changes in climacteric women with chronic low back pain.
【作者单位】：温州医科大学;解放军第117医院放射科;
【基金】：2010年度南京军区医学科技创新课题项目(10MA128) 浙江省医学会临床科研基金项目(2011ZYC-A43)
【分类号】：R445.2;R681.5

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