骨密度对骨质疏松性椎体压缩性骨折PKP术后骨折再发风险的评估价值

发布时间：2018-06-02 02:18

  本文选题：骨质疏松性椎体压缩性骨折 + 骨密度　； 参考：《中国骨质疏松杂志》2017年02期

【摘要】：目的探讨骨质疏松性椎体压缩性骨折(OVCF)患者椎体后凸成形术(PKP)后发生再骨折的影响因素,分析骨密度(BMD)对预测骨折再发的临床价值。方法前瞻性的队列研究纳入我院208例确诊的OVCF并行PKP手术的患者,初次骨折时检测患者骨密度值(BMD)并记录相关临床资料,术后随访2年以上,以患者骨折再发为随访终点事件。采用KaplanMeier分析及多元Cox回归模型进行骨折再发的危险因素分析,受试者工作特征(ROC)曲线用于评估BMD对骨折再发的预测价值。结果 208例OVCF患者PKP术后2年内出现骨折再发共37例(17.8%)。Cox回归分析显示性别、BMD值以及初次双节段骨折是患者骨折再发的独立危险因素。以BMD为预测标准,ROC曲线下面积为0.787,诊断临界点为-3.0SD,灵敏度及特异度分别为83.2%和66.8%。Kaplan-Meier分析结果示BMD-T值-3.0 SD的OVCF患者PKP术后骨折再发率较BMD-T值-3.0 SD更高(P=0.024)。结论骨密度对OVCF患者PKP术后骨折再发的风险具有重要评估价值,尤其对于BMD-T值≤-3.0SD者,在行PKP术时应充分考虑到其术后骨折再发的高风险性。
[Abstract]:Objective to investigate the influencing factors of refracture after kyphoplasty and PKP in patients with osteoporotic vertebral compression fracture (OVCF), and to analyze the clinical value of bone mineral density (BMD) in predicting the recurrence of fracture. Methods A prospective cohort study was conducted in 208 patients with OVCF undergoing PKP operation in our hospital. Bone mineral density (BMD) was measured at the first time of fracture and the clinical data were recorded. The patients were followed up for more than 2 years. The recurrence of fracture was regarded as the end point of follow-up. KaplanMeier analysis and multivariate Cox regression model were used to analyze the risk factors of recurrence of fracture. The operating characteristics of subjects were used to evaluate the predictive value of BMD for recurrence of fracture. Results among the 208 patients with OVCF, the recurrence of fracture occurred within 2 years after PKP in 37 cases. The regression analysis showed that sex and double segment fracture were independent risk factors for the recurrence of fracture. The area under BMD curve was 0.787, the critical point of diagnosis was -3.0 SD.The sensitivity and specificity were 83.2%. The results of 66.8%.Kaplan-Meier analysis showed that the recurrence rate of OVCF patients with BMD-T value -3.0 SD was higher than that of BMD-T value -3.0 SD. Conclusion BMD has important value in evaluating the risk of recurrence of fracture after PKP in patients with OVCF, especially in patients with BMD-T 鈮，

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