OVCF患者椎旁肌密度与椎体骨密度的相关性研究

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摘要目的〓探讨骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture，OVCF)患者腰骶区椎旁肌密度与椎体骨密度(vertebral bone mineral density，vBMD)之间的关系。方法〓回顾性分析了OVCF患者的前瞻性机构数据库(NCT05848167)。纳入2021年1月至2022年12月共167例患者资料，其中101例定量CT(quantitative computed tomography，QCT)检查资料可用的OVCF患者，女80例，男21例；女性中位年龄73(68.00，82.50)岁，男性中位年龄71(67.00，80.00)岁。在L3～5椎体上终板水平进行椎旁肌密度和面积测量，并使用人工分割和定制编写的程序进行计算。利用QCT Pro软件在L1～2水平进行vBMD测量和计算。按性别、年龄对所有分析进行分层分析。结果〓本研究发现男性患者的椎旁肌密度与vBMD有统计学相关。在调整年龄和性别后，L1～2 vBMD与L3左侧多裂肌、L4左侧竖脊肌、L4右侧多裂肌、L5左右双侧多裂肌密度之间存在统计学意义上的正相关，而在女性患者中未发现显著相关性。结论〓男性多裂肌密度和vBMD在不同的腰椎水平存在显著的正相关，这与年龄无关。在解释腰椎椎体和椎旁肌关联时，应考虑性别及区域性差异。

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	侯俊俊1
	2
	侯福山3
	车艳军4*
	张连迂4
	陈琪4
	钱宗娜4
	沈佳莉4
	刘华清5
	司卫兵4
	郝跃峰4
	杨晶1*

关键词 ：椎旁肌密度, 骨质疏松症, 肌少症, 骨质疏松性椎体压缩骨折, 定量CT

Abstract：Objective〓To investigated the correlation between paravertebral muscle density in the lumbosacral region and vertebral bone mineral density (vBMD) as assessed by site-specific quantitative computed tomography (QCT) in patients suffering from osteoporotic vertebral compression fracture (OVCF).Methods〓This study performed a retrospective analysis of a prospective institutional database (NCT05848167)，enrolling patients with osteoporotic spinal fractures.From January 2021 to December 2022，a total of 167 patients were included，among which 101 patients with OVCF ［(80 females and 21 males，with a mean age of 73(68.00，82.50) years for females and 71(67.00，80.00) years for males)］ possessed available examination data，specifically QCT data.Measurements of the posterior paraspinal muscle (PSM) density and area were undertaken at the superior endplate level of the L3～5 vertebral bodies，employing both manual segmentation and custom-developed software.Furthermore，measurements and calculations of vBMD were executed at the L1～2 level using QCT Pro software.All assessments were analyzed with stratification by sex and age.Results〓The analysis revealed a statistically significant correlation between PSM density and vBMD specifically within the male subject cohort.Upon implementing age and sex-specific stratification，a positive statistical association emerged between L1～2 vBMD and the density of multiple posterior paraspinal muscles，including the L3 left multifidus，L4 left erector spinae，L4 right multifidus，and both the L5 left and right bilateral multifidus muscles.In contrast，no significant correlation was detected in the female subject cohort.Conclusion〓The investigation demonstrated a pronounced positive correlation between multifidus muscle density and vBMD across various lumbar vertebral levels specifically in males.Notably，it underscores the importance of accounting for sexual dimorphism and regional variations when elucidating the intricate relationships between lumbar vertebrae and the posterior paraspinal muscles.

基金资助:江苏省双创人才计划项目(JSSCBS20211588)；苏州市姑苏卫生人才计划科研项目(GSWS2021035)；苏州市卫生健康委员会科技项目(DZXYJ202307)；苏州市科技发展计划(医疗卫生科技创新)项目(SKY2022185)；苏州市中西医结合科研基金项目(SKYD2023254)；南京医科大学姑苏学院临床研究项目(GSKY20240208，GSKY20230402)

通讯作者: 杨晶

作者简介: 侯俊俊(1981－ )，女，副主任医师，苏州大学附属第一医院内分泌科，cyj789@163.com

引用本文:

侯俊俊1，2，侯福山3，车艳军4*，张连迂4，陈琪4，钱宗娜4，沈佳莉4，刘华清5，司卫兵4，郝跃峰4，杨晶1*. OVCF患者椎旁肌密度与椎体骨密度的相关性研究[J]. 实用骨科杂志, 2024, 30(7): 594-.
Hou JunJun1，2，Hou Fushan3，CheYanjun4*，Zhang Lianyu4，Chen Qi4，Qian Zongna4，Shen Jiali4，Liu Huaqing5，Si Weibing4，Hao Yuefeng4，Yang Jing1*. Association of Paravertebral Muscle Density with Vertebral Bone Mineral Density in OVCF Patients. sygkzz, 2024, 30(7): 594-.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2024/V30/I7/594

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