摘要
目的 探讨绝经女性患者骨密度(bone mineral density,BMD)对骨关节炎全膝关节置换术恢复情况的预测价值。方法 选取2019年4月至2021年12月湖州市第一人民医院收治的骨关节炎全膝关节置换术患者78例为研究对象,采用双能X线测量患者的BMD水平,术后6个月采用美国膝关节协会评分(Keen Society score,KSS)对膝关节功能进行评估,根据KSS评分将患者分为恢复良好组(n=41)和恢复不良组(n=37);采用Logistic回归分析对患者术后膝关节功能恢复的影响因素进行评估;利用R软件建立预测列线图模型;绘制受试者操作特征曲线分析构建模型的预测效能。结果 术后6个月,非骨质疏松患者的KSS评分均显著高于骨质疏松患者(P<0.05)。两组患者的年龄、病程、绝经时间、BMD及体质量指数(body mass index,BMI)比较差异均有统计学意义(P<0.05)。多因素Logistic回归分析表明,年龄、BMI、病程、绝经时间及BMD均是影响骨关节炎全膝关节置换术后关节功能恢复的独立危险因素(P<0.05)。列线图构建关节功能恢复预测模型的曲线下面积为0.832 (95%CI:0.762~0.883),预测的敏感度与特异性较高。结论 绝经女性患者BMD对骨关节炎全膝关节置换术后关节功能恢复产生影响,建立的列线图对判断预后具有较高应用价值。
Objective To investigate the predictive value of bone mineral density(BMD)of menopausal women on the recovery of total knee arthroplasty for osteoarthritis.Methods Seventy-eight patients with total knee arthroplasty for osteoarthritis admitted to Huzhou First People’s Hospital from April 2019 to December 2021 were selected as the study objects.BMD levels were measured by dual-energy X-ray,and knee function was assessed by Keen Society score(KSS)6 months after surgery.Patients were divided into good recovery group(n=41)and poor recovery group(n=37)according to the KSS score.Logistic regression analysis was used to evaluate influencing factors for postoperative knee functional recovery.The prediction nomogram model was established by using R software.The receiver operating characteristic curve was drawn to analyze the predictive performance of the constructed model.Results After 6 months of surgery,KSS scores of non-osteoporosis patients were significantly higher than those of osteoporosis patients(P<0.05).There were statistically significant differences in age,course of disease,time of menopause,BMD and body mass index(BMI)between the two groups(P<0.05).Multivariate Logistic regression showed that age,BMI,course of disease,time of menopause and BMD were independent risk factors for joint function recovery after total knee arthroplasty for osteoarthritis(P<0.05).The area under the curve of the prediction model were 0.832(95%CI:0.762-0.883),which showed high sensitivity and specificity.Conclusion BMD of menopausal women has an impact on the recovery of joint function after total knee arthroplasty for osteoarthritis,and the nomogram established has a high application value in judging the prognosis.
作者
章旭
张占丰
施晶晶
谢斌
ZHANG Xu;ZHANG Zhanfeng;SHI Jingjing;XIE bin(Department of Orthopaedics,Huzhou First People’s Hospital,Huzhou 313000,Zhejiang,China)
出处
《中国现代医生》
2023年第25期14-17,44,共5页
China Modern Doctor
基金
浙江省医药卫生科技计划项目(2021KY346)
湖州市科学技术项目(2020GYB26)。
关键词
绝经女性
骨密度
骨关节炎
全膝关节置换术
预测效能
Menopause women
Bone mineral density
Osteoarthritis
Total knee arthroplasty
Predictive effectiveness
