摘要
目的：借助MRI评估不同绝经年限的健康绝经后妇女L1～S1椎间盘的退变程度，进而探讨绝经年限与腰椎间盘退变的相关性。方法：按照纳入标准筛选出589例健康自然绝经后妇女，记录其年龄、身高、体质量、绝经年龄及绝经年限。按改良Pfirmmann椎间盘退变分级系统在1.5TMRI图像上进行分级。结果：所有绝经后妇女腰椎间盘均发生退变。调整年龄、身高、体质量，当绝经年限≤15年时，绝经年限与L1/L2（r=0.235）、L2/L3（r=0.161）、L3/L4（r=0.173）、L4/L5（r=0.146）、L5/S1（r=0.137）以及总体椎间盘（r=0.259）退变程度均呈正相关（P＜0.05，0.01）；按绝经年限分三组（绝经后1～5年、6～10年、11～15年），组间退变程度差异有统计学意义（P＜0.05）。当绝经年限＞15年时，绝经年限与各腰椎间盘退变均无显著相关性（P＞0.05）；三组间（绝经后16～20年、21～25年、26～30年）退变程度差异无统计学意义（P＞0.05）。多元逐步回归分析结果显示，绝经年限对各椎间盘退变变异贡献大小分别为：L1/L2（40.3%）、L2/L3（29.1%）、L3/L4（27.6%）、L4/L5（18.2%）、L5/S1（16.3%）、总体（42.9%）。结论：绝经年限与腰椎间盘退变存在一定的相关性。退变过程主要发生在绝经后15年内，表明绝经后雌激素的减少可能在一定时间内会加快腰椎间盘退变。
Objective： To investigate, in a population of healthy postmenopausal women, the relationship of years since menopause （YSM） with lumbar intervertebral disc degeneration between the 1st lumbar and 1st sacral vertebrae, with magnetic resonance imaging （MRI）.Methods： Selected 589 healthy postmenopausal women in ac-cordance with the inclusion criteria, recording their age, height, weight, age at menopause and YSM. Disc degenera-tion was assessed using a modiifed Pifrrmann grading system on 1.5T MRI.Results： All postmenopausal women’s lumbar intervertebral disc were degeneration. After removing age, height and weight effect, when YSM≤15 years, a positive trend was observed between YSM and severity of disc degeneration, respectively that L1/L2 （r=0.235）, L2/L3 （r=0.161）, L3/L4 （r=0.173）, L4/L5 （r=0.146）, L5/S1 （r=0.137） and all lumbar disc （r=0.259） （P〈0.05 or 0.01）. According to YSM, the subjects were divided into 3 groups separately, namely, 1~5 YSM, 6~10 YSM and 11~15 YSM. There was signiifcant difference between each other （P〈0.01）. When YSM〉15 years, there was no signiifcant correlation between YSM and severity of disc degeneration （P〉0.05）. Goups of 16~20 YSM, 21~25 YSM and 26~30 YSM had no signiifcant difference between each other （P〉0.05）. Multiple stepwise regression analysis showed that the effect of YSM on each disc degeneration mutation was respectively L1/L2 （40.3%）, L2/L3 （29.1%）, L3/L4 （27.6%）, L4/L5（18.2%）, L5/S1 （16.3%） and total （42.9%）.Conclusion： There is a correlation between YSM and lum-bar intervertebral disc degeneration. After menopause, lumbar intervertebral disc degeneration shows a progressive aggravation that almost entirely occurs in the ifrst 15 years since menopause, showing that the estrogen decrease in postmenopausal women may accelerate the degeneration of lumbar intervertebral disc in a certain period of time.
出处
《温州医学院学报》
CAS
2014年第6期421-425,共5页
Journal of Wenzhou Medical College
基金
温州市科技局科研基金资助项目(Y20090272)
关键词
绝经
退变
椎间盘
腰椎
menopause
degeneration
intervertebral disc
lumbar spine
