性别、年龄差异性对高位腰椎间盘突出症患者的影响研究

发布时间：2018-05-17 19:26

本文选题：高位腰椎间盘突出症 + 性别　；参考：《河北医科大学》2015年硕士论文

【摘要】：目的:高位腰椎间盘突出症是导致腰腿痛最为常见的原因之一,是指腰椎间盘退变、纤维环破裂后髓核向后方突出或突出至椎板内压迫和刺激相邻组织导致的综合性临床症状。在高位腰椎间盘突出症患者中男女比例约为3.7:1,且随着年龄的增加,腰椎退变程度的加重,高位腰椎间盘突出症临床特征明显加重。通过对高位腰椎间盘突出症患者的病例调查分析,探讨了性别、年龄差异对高位腰椎间盘突出症的影响,以期为临床治疗提供参考。方法:1回顾性分析2013年至2015年河北医科大学第三医院骨科住院的高位腰椎间盘突出症患者96例,其中男性60例,女性36例,年龄33~63岁,平均年龄(47.68±9.51)岁。2全部患者均采用SIEMENS Verio SQ3.0T超导MR扫描仪器行磁共振成像(magnetic resonance imaging,MRI)检查,参照T2WI矢位、轴位扫描,设置MRI扫描参数为体部线圈,T2WI矢位,仰卧位,TE:101,TR:3000,扫描层厚:4 mm,间距:1.1mm,距阵384×288,FOV:300×300。T2WI轴位TE:112,TR:3500,扫描层厚:4 mm,间距:0.2mm,距阵320×240,FOV:220×220。3按照性别分为男性组(n=60)与女性组(n=36)。按照年龄将患者分为高龄组(年龄≥48岁,50例)与低龄组(年龄48岁,46例)。比较两组间腰椎间盘突出症病变分级、MRI信号强度、Oswestry功能障碍指数(Oswestry disability index,ODI)评分和日本矫形协会(Japanese Orthopedic Association,JOA)评分。4采用SPSS19.0统计软件处理数据。结果:1在96例高位腰椎间盘突出症患者中,参照Pfirrmann腰椎间盘突出症MRI分级标准进行分级,男女两组在不同MRI等级的分布存在明显差异(P0.05),提示男性组比女性组病变程度严重。女性组椎间隙髓核信号强度和椎间隙髓核信号强度/脑脊液信号强度比值高于男性组,两组间差异具有统计学意义(P0.05)。女性组高位腰椎间盘突出症患者ODI评分低于男性组(P0.05),两组间差异具有统计学意义(P0.05);女性组高位腰椎间盘突出症患者JOA评分高于男性组,两组间差异具有统计学意义(P0.05)。2在96例高位腰椎间盘突出症患者中,参照Pfirrmann腰椎间盘突出症MRI分级标准进行分级,高龄组与低龄组在不同MRI等级的分布存在明显差异(P0.05),提示高龄组比低龄组病变程度严重。低龄组椎间隙髓核信号强度、椎间隙髓核信号强度与脑脊液信号强度比值高于高龄组,两组间差异具有统计学意义(P0.05),低龄组ODI评分低于高龄组,两组间差异具有统计学意义(P0.05),低龄组JOA评分高于高龄组,两组间差异具有统计学意义(P0.05)。结论:1参照Pfirrmann腰椎间盘突出症MRI分级标准,男女两组在不同等级比较存在差异,提示男性组比女性组病变程度更严重。2高位椎间盘突出症女性患者椎间隙髓核信号强度、椎间隙髓核信号强度与脑脊液信号强度比值显著高于男性患者,提示相同年龄段同一椎间盘男性比女性退变严重。3高位椎间盘突出症女性患者ODI评分低于男性患者,JOA评分高于男性患者,提示高位椎间盘突出症女性患者病变程度较轻,男性高位椎间盘突出症患者病变程度较为严重。4参照Pfirrmann腰椎间盘突出症MRI分级标准,高龄组与低龄组在不同等级比较存在差异,提示高龄组比低龄组病变程度更严重。5高位椎间盘突出症低龄患者椎间隙髓核信号强度、椎间隙髓核信号强度与脑脊液信号强度比值显著高于高龄患者,揭示了低龄高位椎间盘突出症患者病变程度较轻,高龄高位椎间盘突出症患者病变程度较重。6高位椎间盘突出症低龄患者ODI评分低于高龄患者,JOA评分高于高龄患者,提示高位椎间盘突出症低龄患者病变程度较轻,高龄高位椎间盘突出症患者病变程度较为严重。
[Abstract]:Objective: high lumbar intervertebral disc herniation is one of the most common causes of lumbago and leg pain, which refers to the comprehensive clinical symptoms of lumbar disc degeneration, the nucleus pulposus protruding back to the rear after the rupture of the fibrous ring or the compression of the intervertebral lamina and stimulation of adjacent tissues. The proportion of men and women in the patients with high lumbar intervertebral disc protrusion is about 3.7:1 and with the year. The increase of age, the aggravation of lumbar degeneration, the clinical features of high lumbar intervertebral disc herniation are obviously aggravated. Through the investigation and analysis of patients with high lumbar intervertebral disc herniation, the influence of sex and age on high lumbar intervertebral disc herniation is discussed in order to provide reference for clinical treatment. Method: 1 retrospective analysis from 2013 to 2015 96 cases of high lumbar intervertebral disc herniation in the Department of orthopedics, Third Hospital of Hebei Medical University, including 60 males and 36 females, age 33~63 years, the average age of (47.68 + 9.51) years old.2 all were examined by SIEMENS Verio SQ3.0T superconducting MR scanner (magnetic resonance imaging, MRI), with reference to T2WI sagittal, axis Bit scan, set MRI scanning parameters for body coil, T2WI vector position, supine position, TE:101, TR:3000, scanning layer thickness: 4 mm, spacing: 1.1mm, distance matrix 384 x 288, FOV:300 x 300.T2WI axis TE:112, TR:3500, scanning layer thickness: 4 mm, spacing: 0.2mm, 320 x 240, 220 * 220.3 according to sex. The patients were divided into older age group (age 48 years old, 50 cases) and low age group (age 48 years, 46 cases). Compared with two groups of lumbar intervertebral disc herniation classification, MRI signal intensity, Oswestry dysfunction index (Oswestry disability index, ODI) score and Japanese Orthopedic Association (Japanese Orthopedic Association, JOA) score.4 by SPSS19.0 statistical software treatment Data. Results: 1 in 96 cases of high lumbar intervertebral disc herniation, according to the Pfirrmann lumbar disc herniation MRI grading standard, the distribution of two groups of men and women in different MRI levels was significantly different (P0.05), suggesting that the male group was more serious than the female group. The intensity of intervertebral nucleus pulposus signal intensity and intervertebral nucleus pulposus signal intensity in the female group were strong. The ratio of the intensity / cerebrospinal fluid signal intensity was higher than that of the male group. The difference between the two groups was statistically significant (P0.05). The ODI score of the high lumbar disc herniation patients in the female group was lower than that of the male group (P0.05), and the difference between the two groups was statistically significant (P0.05); the JOA score of the high lumbar disc herniation in the female group was higher than that in the male group, and the difference between the two groups was significant. Statistical significance (P0.05).2 was graded in 96 cases of high lumbar intervertebral disc herniation with reference to the MRI grading standard of Pfirrmann lumbar intervertebral disc herniation. The distribution of the elderly group and the lower age group was significantly different in the different MRI grades (P0.05), suggesting that the age group was more serious than the lower age group. The signal intensity of intervertebral nucleus pulposus and the intervertebral space in the lower age group were more than the lower age group. The ratio of signal intensity of nucleus pulposus and signal intensity of cerebrospinal fluid was higher than that of the elderly group (P0.05), and the ODI score of the low age group was lower than that of the elderly group, and the difference between the two groups was statistically significant (P0.05), the JOA score of the low age group was higher than the older group, and the difference between the two groups was statistically significant (P0.05). Conclusion: 1 reference to the Pfirrmann lumbar intervertebral disc. The two groups of men and women were different in different grades, suggesting that the male group was more serious than the female group, and the intensity of intervertebral nucleus signal intensity was more serious in the female patients with.2 high disc herniation. The ratio of the intervertebral nucleus signal intensity to the signal intensity of the cerebrospinal fluid was significantly higher than that of the male patients, suggesting the same age segment of the same vertebra. The ODI score of the male patients with severe.3 high disc herniation was lower than that of the male patients, and the JOA score was higher than that of the male patients. It suggested that the degree of pathological changes in the female patients with high disc herniation was lighter, and the severity of the male high disc herniated patients was more serious.4 refer to the MRI grading standard of the Pfirrmann lumbar disc herniation. The age group and the lower age group were different in different grades, suggesting that the age group was more serious than the lower age group, and the intensity of intervertebral nucleus pulposus signal of.5 high disc herniated lower age patients, the ratio of intervertebral nucleus signal intensity to the signal intensity of cerebrospinal fluid was significantly higher than those of the elderly, and revealed the low age high disc herniation disease. The degree of pathological changes of the patients with high age intervertebral disc herniation is lower than that of the elderly patients with high.6 high disc herniation, and the JOA score is higher than that of the older patients. It suggests that the degree of pathological changes in the lower age patients with high disc herniation is lighter, and the patients with high vertebral disc herniation are more serious.
【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

【参考文献】