磁共振成像下高位腰椎间盘突出症与多裂肌退变的相关性研究

发布时间：2018-10-24 14:24

【摘要】：目的:以MRI为评估手段,比较高位腰椎间盘突出症患者与正常人的腰椎多裂肌脂肪浸润程度、面积及厚度,探讨高位腰椎间盘突出症与腰椎多裂肌改变的相关性。方法:采用回顾性研究方法,选取2012年6月份至2016年12月份在我院脊柱骨病外科住院治疗的66例高位腰椎间盘突出症患者为病例组,其中男性41例,女性25例,年龄为21-64岁。选取在我院体检的资料齐全健康人66例作为对照组,其中男性41例,女性25例,年龄为24-62岁。选取MRI图像T2加权像L1/2、L2/3、L3/4节段椎间盘平面作为测量平面,应用PACS系统测量工具分别测量了不同节段腰椎多裂肌的总截面积、单纯多裂肌截面积、多裂肌厚度,并且评估了双侧多裂肌的脂肪浸润程度。以Excel整理和录入原始数据资料,应用软件SPSS 17.0进行统计分析。数据计量资料均进行正态性检验,均符合正态性分布,采用方差分析进行比较,使用均数±标准差(`X±SD)表示;计数资料使用卡方分析,用例数(n)和百分比(%)描述;运用多因素Logistic回归计算各比值比(odds ratios,OR)和95%可信区间(confidence intervals,CI)。p0.05认为差异有统计学意义。结果:卡方分析和方差检验显示,高位腰椎间盘突出症病人具有年龄大、BMI偏大、总多裂肌截面积减少、总单纯多裂肌截面积减少、平均多裂肌厚度较小、脂肪化程度较高的特点,差异均有统计学意义(P0.05)。多因素logistics回归分析显示,年龄的增加、总多裂肌截面积的减少、总单纯多裂肌截面积的减少、平均多裂肌厚度降低、脂肪化程度较高均为高位腰椎间盘突出症的危险因素,差异均有统计学意义(P0.05)。结论:腰椎多裂肌的退变与高位腰椎间盘突出症存在一定的相关性。高位腰椎间盘突出症患者多裂肌明显萎缩,主要表现为多裂肌的面积减小,多裂肌的厚度降低以及多裂肌的脂肪化程度增高。
[Abstract]:Objective: to compare the degree, area and thickness of fat infiltration of lumbar polyfissure muscle between patients with high lumbar disc herniation and normal subjects by MRI, and to explore the correlation between high lumbar disc herniation and changes of lumbar polyfissure muscle. Methods: a retrospective study was conducted in 66 patients with high lumbar disc herniation in our hospital from June 2012 to December 2016, including 41 males and 25 females aged 21-64 years. A total of 66 healthy persons, including 41 males and 25 females aged 24 to 62 years, were selected as control group. The plane of intervertebral disc of L1 / 2 / L2 / 3 / 3 / 4 segment of MRI images was selected as the measuring plane. The total sectional area, the sectional area of pure polyphagus muscle and the thickness of polyfissure muscle were measured by PACS system, respectively. The degree of fat infiltration of bilateral polyfissure muscles was evaluated. Using Excel to sort out and input the original data, the software SPSS 17.0 was used for statistical analysis. The data were tested by normal distribution, and compared with each other by means of ANOVA (mean 卤standard deviation) (`X 卤SD), the counting data were described by chi-square analysis, (n) and percentage (%). The ratio (odds ratios,OR) and 95% confidence interval (confidence intervals,CI) were calculated by multivariate Logistic regression. Results: chi-square analysis and variance test showed that the patients with high lumbar disc herniation had older age, larger BMI, less total polyfissure muscle cross-sectional area, less total simple polyfissure muscle cross-sectional area and smaller average polyfissure muscle thickness. Fatty degree of the characteristics of higher, the differences were statistically significant (P0.05). Multivariate logistics regression analysis showed that the increase of age, the decrease of total polyfissure muscle cross-sectional area, the decrease of total pure polyfissure muscle cross-sectional area, the decrease of average polyfissure muscle thickness and the higher degree of fat were all risk factors of high lumbar disc herniation. The difference was statistically significant (P0.05). Conclusion: there is a certain correlation between the degeneration of lumbar polyfissure muscle and high lumbar disc herniation. In the patients with high lumbar disc herniation, the polyfissure muscle shrank obviously, the area of the polyfissure muscle decreased, the thickness of the polyfissure muscle decreased, and the fatty degree of the polyfissure muscle increased.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R681.53

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