摘要
目的 探讨L3椎旁肌群指数与骨密度(bone mineral density, BMD)的相关性以及如何将该指标运用于骨质疏松症的诊断。方法 回顾性分析2022年2月至2022年11月在江苏省第二中医院进行腰椎椎体CT平扫+重建及骨密度测定的符合入组标准的173名患者,采集患者L3椎体层面椎旁后肌群(多裂肌和竖脊肌)及腰大肌(椎旁前肌群)面积,计算出L3水平的椎旁肌群指数、腰大肌指数(psoas muscle index, PMI),并根据双能DXA骨密度仪测出的T值将其分为骨质疏松症组和非骨质疏松症组。采用Spearman等级相关分析椎旁肌群指数、PMI与BMD的相关性。用受试者工作特征(ROC)分析椎旁肌群指数和PMI预测骨质疏松症的有效性。结果 在BMD中,椎旁肌群指数与腰大肌指数均与其呈显著相关(椎旁肌群指数:L1 r=0.595,L2 r=0.549,L3 r=0.653,L4 r=0.661,L_(1~4)r=0.692,股骨颈r=0.575;腰大肌指数:L1 r=0.551,L2 r=0.508,L3 r=0.576,L4 r=0.569,L_(1~4)r=0.614,股骨颈r=0.474;P均<0.001)。骨质疏松症患者椎旁肌群指数显著低于非骨质疏松症患者(P<0.01)。ROC曲线分析表明,椎旁肌群指数(AUC:0.813)诊断准确率优于PMI(AUC:0.784)。结论 随着年龄增长,椎旁肌群在不断改变,对于已完善腰椎CT的患者,L3椎旁肌群指数以及PMI和BMD显著相关,且椎旁肌群指数在诊断骨质疏松症方面优于PMI,故运用椎旁肌群指数可以在一定程度上辅助临床医生诊断骨质疏松症。
Objective To explore the correlation between L3-paraspinal muscle group index and bone mineral density,and the application of this index in the diagnosis of osteoporosis.Methods Retrospective analysis was made on 173 patients with lumbar vertebral body CT plain scan and bone mineral density measurement from February 2022 to November 2022.The areas of posterior paraspinal muscles(multifidus and erector spinae)and psoas major muscles(anterior paraspinal muscles)at L3 vertebral level were collected,and the paraspinal muscle group index and psoas major muscle index(PMI)at L3 level were calculated.Spearman grade correlation was used to analyze the correlation between paraspinal muscle index,PMI and BMD.The effectiveness of paravertebral muscle group index and PMI in predicting osteoporosis was analyzed by ROC.Results In a single lumbar vertebra and the whole lumbar vertebra and femoral neck,the paravertebral muscle group index and psoas major index were significantly correlated with bone mineral density(paravertebral muscle group index:L1 r=0.595,L2 r=0.549,L3 r=0.653,L4 r=0.661,L_(1-4) r=0.692,femoral neck r=0.575;Psoas index:L1 r=0.551,L2 r=0.508,L3 r=0.576,L4 r=0.569,L_(1-4) r=0.614,femoral neck r=0.474;P<0.001).The index of paravertebral muscles in osteoporosis patients was significantly lower than that in osteoporosis patients(P<0.01).ROC curve analysis showed that the diagnostic accuracy of paravertebral muscle group index(AUC:0.813)was better than that of psoas major index(AUC:0.784).Conclusion This study shows that the paravertebral muscle groups are constantly changing with age.For patients with improved lumbar CT,the paravertebral muscle group index and psoas major index of L3 are significantly correlated with BMD,and the paravertebral muscle group index is superior to psoas major index in diagnosing osteoporosis.Therefore,using paravertebral muscle group index can help clinicians diagnose osteoporosis to a certain extent.
作者
王凯韬
李志伟
顾埮钜
陈帅
金杰
WANG Kaitao;LI Zhiwei;GU Tanju;CHEN Shuai;JIN Jie(The Second Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210017,China;Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2023年第6期858-863,共6页
Chinese Journal of Osteoporosis
基金
江苏省老年健康科研重点课题项目(LKZ2022008
LKZ2023004)。
关键词
椎旁肌群指数
腰大肌指数
骨密度
骨质疏松症
paravertebral muscle group index
psoas muscle index
bone mineral density
osteoporosis
