壮族人群膝骨关节炎临床表现与X线影像的相关性研究

发布时间：2018-08-27 07:49

【摘要】：目的:通过对壮族人群膝骨关节炎患者的临床症状和X线影像进行量化评估,探讨壮族人群膝骨关节炎临床分级与X线分级、X线测量7组数据的关系。方法:1.选择符合膝骨关节炎诊断标准的壮族患者170例,按照临床分级标准将病例分成5组,并将其患膝的X线影像按照Kellgren-Lawrence(K/L)分级分为5级。用Spearman分析方法对临床分级与X线分级的关系进行双变量相关分析。2.测量170例患者膝关节X线影像的胫股关节内侧间隙宽度(数据1)、胫股关节外侧间隙宽度(数据2)、髌股关节间隙宽度(数据3)、胫股关节内侧间室骨赘长度(数据4)、胫股关节外侧间室骨赘长度(数据5)、髌股关节间室骨赘长度(数据6)、胫股关节间隙角(数据7)共7组数据。用Spearman分析方法对临床分级与X线测量的7组数据的关系进行双变量相关分析。结果:1.临床分级1-5级例数分别为1级33例、2级35例、3级42例、4级30例、5级30例。X线K/L分级1-5级例数分别为1级0例、2级58例、3级58例、4级32例、5级22例。X线K/L分级1、2、3、4、5级与临床分级1、2、3、4、5级符合程度分别是1级0%、2级29.31%、3级31.04%、4级37.50%、5级72.72%。临床分级与X线K/L分级呈正相关性,相关系数r值为0.745,P0.05。2.临床分级与X线影像测量7组数据中的数据1、2、3呈负相关性,数据4、5、6呈正相关性,数据7无明显的相关性。具体如下:(1)临床分级与胫股关节内侧间隙宽度(数据1)、胫股关节外侧间隙宽度(数据2)、髌股关节间隙宽度(数据3)呈负相关性,相关系数r值分别为-0.737、-0.324、-0.496,P均0.05。(2)临床分级与胫股关节内侧间室骨赘长度(数据4)、胫股关节外侧间室骨赘长度(数据5)、髌股关节间室骨赘长度(数据6)呈正相关性,相关系数r值分别为0.560、0.438、0.504,P均0.05。(3)临床分级与胫股关节间隙角(数据7)无明显相关性,相关系数r值为0.145,P=0.059。结论:1.壮族人群膝骨关节炎临床表现与X线影像的K/L分级呈正相关性;且随着膝骨关节炎进展,临床表现与X线影像的K/L分级吻合度越来越高。2.壮族人群膝骨关节炎临床表现与X线影像的胫股关节内侧间隙宽度、胫股关节内侧间室骨赘长度的关系最密切。在临床X线阅片时,应更加重视胫股关节内侧间隙宽度、胫股关节内侧间室骨赘长度的改变。
[Abstract]:Objective: to evaluate the clinical symptoms and X-ray images of patients with knee osteoarthritis in Zhuang nationality, and to explore the relationship between clinical grade of knee osteoarthritis and X-ray measurement of 7 groups in Zhuang nationality. Method 1: 1. One hundred and seventy Zhuang patients who met the diagnostic criteria of knee osteoarthritis were divided into 5 groups according to the clinical grading criteria. The X-ray images of the affected knees were divided into 5 grades according to the Kellgren-Lawrence (K / L) grade. The relationship between clinical grade and X-ray grade was analyzed by Spearman. 2. 2. The width of medial space of tibiofemoral joint (data 1), the width of lateral space of tibiofemoral joint (data 2), the width of space of patellofemoral joint (data 3) and the length of osteophyte in medial compartment of tibiofemoral joint were measured in 170 patients. The length of osteophyte in the lateral compartment of tibiofemoral joint (data 5), the length of osteophyte in interarticular compartment of patellofemoral joint (data 6) and the angle of tibiofemoral joint space (data 7) were observed in 7 groups. The relationship between clinical grade and 7 groups of X-ray data was analyzed by Spearman. The result is 1: 1. Clinical grade 1-5 cases: 1 33 cases, grade 2 35 cases, grade 3 42 cases, grade 4 cases, grade 5 cases 30 cases. The number of cases of grade 1, grade 2, class 1, grade 3, class 2, grade 2, grade 22 The coincident degree with clinical grade 1 was 0 and 2 with 29.31 and 3 with 31.044 and 37.50 with 5 grade 72.72. There was a positive correlation between clinical grade and X ray K / L grade, the correlation coefficient r value was 0. 745% (P 0. 05.2). There was a negative correlation between clinical grade and X-ray imaging data of 7 groups. There was a positive correlation between clinical grade and X ray imaging data in 7 groups, but there was no significant correlation in data 7. The main results are as follows: (1) the clinical grade was negatively correlated with the width of medial space of tibiofemoral joint (data 1), the width of lateral space of tibiofemoral joint (data 2) and the width of space of patellofemoral joint (data 3). The correlation coefficient r values were -0.737- 0.324- 0.496g P respectively. (2) the clinical grade was positively correlated with the length of medial compartment osteophyte of tibiofemoral joint (data 4), the length of osteophyte of lateral compartment of tibiofemoral joint (data 5), the length of interarticular osteophyte of femoral joint (data 6). The correlation coefficient (r) was 0. 560 ~ 0. 438 ~ 0. 504 (P = 0. 05). (3) there was no significant correlation between clinical grade and tibiofemoral joint space angle (data 7). The correlation coefficient r value was 0. 145 ~ 0. 059. Conclusion 1. The clinical manifestations of knee osteoarthritis in Zhuang nationality were positively correlated with the K / L grade of X-ray images, and with the progression of knee osteoarthritis, the clinical manifestations were more and more consistent with the K / L grade of X-ray images. The clinical manifestation of knee osteoarthritis in Zhuang nationality was most closely related to the width of medial space of tibiofemoral joint and the length of osteophyte in medial compartment of tibiofemoral joint. More attention should be paid to the width of medial space of tibiofemoral joint and the length of osteophyte in medial compartment of tibiofemoral joint.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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