|
| 慢性腰腿痛患者骨密度与腰椎间盘退变严重程度的相关性 |
| Correlation analysis between bone mineral density and severity of lumbar disc degeneration in patients with chronic lumbocrural pain |
| |
| DOI：10.3969/j.issn.1006-7108.2026.10.005 |
| 中文关键词: 骨密度 腰椎间盘退变 慢性腰腿痛 Pfirrmann分级 |
| 英文关键词:bone mineral density lumbar disc degeneration chronic lumbocrural pain Pfirrmann classification |
| 基金项目:国家自然科学基金面上项目（82474529）；江苏省自然科学基金面上项目（BK20241802）；江苏省中医药领军人才培养项目(SLJ0310) ；江苏省中医药科技发展计划面上项目（MS2022080） |
|
| 摘要点击次数: 80 |
| 全文下载次数: 0 |
| 中文摘要: |
| 目的 探讨慢性腰腿痛患者骨密度（bone mineral density，BMD）与腰椎间盘退变（lumbar disc degeneration，LDD）严重程度的相关性，为临床评估及疾病预测提供参考。方法 采用回顾性分析方法，纳入2021年1月至2022年5月诊治的361例40～80岁慢性腰腿痛患者。采用双能X线骨密度仪检测患者腰椎（L1-L4）、左侧髋关节及左侧股骨颈BMD（以T值表示），并依据WHO标准进行3种独立分组，其中左侧髋关节BMD分组作为全身BMD代表用于主要分析。采用Pfirrmann分级系统评估L1-S1各节段椎间盘退变程度并计算平均LDD评分。采用Spearman相关性分析、多元线性回归探讨BMD与LDD的关系，并辅以有序Logistic回归进行敏感性分析。结果 根据左侧髋关节BMD分组，骨质疏松组及骨量减少组患者年龄更大、BMI更低且女性占比更高（均P＜0.001）。3种BMD分组方式下，骨质疏松组LDD评分均高于骨量正常组（均P＜0.05）。相关性分析显示各部位BMD均与LDD程度呈负相关（r=-0.406、-0.392、-0.340，均P＜0.001）。多元线性回归显示骨质疏松是LDD加重的独立危险因素（以左髋分组为例：β=0.180，P=0.028，其他部位分组呈现类似趋势）。有序Logistic回归的敏感性分析进一步支持了此关联的稳健性。结论 在慢性腰腿痛患者中，BMD降低与LDD严重程度显著相关，BMD越低，LDD程度越严重。这表明系统性骨代谢异常可能与椎间盘退行性病变存在共同的病理过程。 |
| 英文摘要: |
| Objective This study aimed to investigate the correlation between bone mineral density (BMD) and the severity of lumbar disc degeneration (LDD) in patients with chronic lumbocrural pain, so as to provide a reference for clinical evaluation and disease prediction. Methods A retrospective analysis was conducted, including 361 patients aged 40 to 80 years with chronic low back and leg pain who were diagnosed and treated between January 2021 and May 2022. Dual-energy X-ray absorptiometry (DXA) was used to measure the BMD (expressed as T-score) of the lumbar spine (L1–L4), left hip joint, and left femoral neck. Participants were divided into three independent groups based on WHO criteria, with the left hip BMD group serving as the representative for whole-body BMD in the primary analysis. The Pfirrmann grading system was used to assess the degree of disc degeneration in each segment from L1 to S1 and calculate the average LDD score. Spearman correlation analysis and multiple linear regression were employed to explore the relationship between BMD and LDD, supplemented by ordered logistic regression for sensitivity analysis. Results Patients in the osteoporosis and osteopenia groups, as classified by left hip BMD, were older, had lower BMI, and included a higher proportion of females (all P<0.001). Across all three BMD classification groups, the LDD scores in the osteoporosis group were consistently higher than those in the normal BMD group (all P<0.05). Correlation analysis revealed that BMD at all sites was negatively correlated with LDD severity (r=-0.406, -0.392, -0.340, all P<0.001). Multivariate linear regression revealed osteoporosis as an independent risk factor for LDD progression (e.g., left hip subgroup: β=0.180, P=0.028; similar trends observed in other site subgroups). Sensitivity analysis using ordered logistic regression further supported the robustness of this association. Conclusion In patients with chronic lumbocrural pain, reduced BMD is significantly correlated with the severity of LDD, and the lower the BMD, the more severe the LDD. This suggests that systemic bone metabolism disorders and intervertebral disc degeneration may share common pathological mechanisms. |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|