摘要
目的探讨后凸Cobb's角、骨密度(BMD)、Ⅰ型前胶原氨基端前肽(P1NP)对骨质疏松性椎体压缩性骨折(OVCF)患者球囊扩张椎体后凸成形术(PKP)术后再发骨折风险的预测价值。方法选取2018年12月—2020年6月石家庄市人民医院骨科收治的行PKP术的OVCF患者110例作为研究对象,进行2年随访,根据随访过程中是否出现新发骨折分为再发骨折组28例和未再发骨折组82例。比较2组患者一般资料及术后指标,Cox分析影响PKP术后再发骨折的危险因素,绘制ROC曲线分析后凸Cobb's角、BMD、P1NP对OVCF患者PKP术后再发骨折的预测价值。结果随访期间骨折再发生率为25.45%(28/110)。再发骨折组后凸Cobb's角、P1NP高于未再发骨折组,BMD低于未再发骨折组,差异具有统计学意义(t/P=4.678/<0.001,4.591/<0.001,4.784/<0.001);Cox分析结果显示,后凸Cobb's角增大、BMD降低、P1NP升高均是影响PKP术后再发骨折的危险因素[OR(95%CI)=1.394(1.135~1.712)、1.910(1.127~3.236)、2.140(1.084~4.225),P<0.05];ROC曲线分析显示,后凸Cobb's角≥5.87°、BMD≤-3.38 SD、P1NP≤50.67μg/L为截断值,后凸Cobb's角、BMD、P1NP预测OVCF患者PKP术后再发骨折的AUC分别为0.725、0.846、0.836,3项联合AUC为0.899,高于单项检测(Z/P=8.129/<0.001,7.195/<0.001,7.695/<0.001)。结论定期监测后凸Cobb's角、BMD、P1NP水平可在早期预测OVCF患者PKP术后再发骨折风险以便及时给予干预措施。
Objective To investigate the predictive value of posterior convexity Cobb's angle,bone mineral density(BMD),and pre-collagen type I amino-terminal pre-peptide(PⅠNP)on the risk of recurrent fracture in osteoporotic vertebral compression fracture(OVCF)patients following balloon dilatation vertebral kyphoplasty(PKP).Methods One hundred and ten OVCF patients who underwent PKP admitted to the Department of Orthopedics of Shijiazhuang People's Hospital from December 2018 to June 2020 were selected as study subjects for 2-year follow-up,and were categorized into 28 cases in the recurrent fracture group and 82 cases in the non-recurrent fracture group according to whether new fractures appeared in the follow-up process.Comparing the general data and postoperative indexes of patients in the 2 groups,Cox analyzed the risk factors affecting the recurrent fracture after PKP,and drew ROC curve to analyze the predictive value of posterior convex Cobb's angle,BMD,and P1NP on the recurrent fracture after PKP in patients with OVCF.Results There were 28 cases of new fractures during the follow-up period,and the fracture recurrence rate was 25.45%(28/110).The Cobb's angle of posterior convexity and P1NP of the recurrent fracture group were higher than that of the non-recurrent fracture group,and the BMD was lower than that of the non-recurrent fracture group,and the differences were statistically significant(t/P=4.678/<0.001,4.591/<0.001,4.784/<0.001);Cox analysis showed that increased posterior convex Cobb's angle,decreased BMD,and elevated P1NP were all risk factors for recurrent fracture after PKP[OR(95%CI)=1.394(1.135-1.712),1.910(1.127-3.236),2.140(1.084-4.225),P<0.05];ROC curve analysis showed that posterior convex Cobb's angle≥5.87°,BMD value≤-3.38 SD,and PⅠNP≤50.67μg/L were the cut-offs,and the posterior convex Cobb's angle,BMD,PⅠNP predicted the AUC of 0.725,0.846,and 0.836 for postoperative recurrent fractures after PKP in patients with OVCF,respectively,and the combined AUC of the 3 items was 0.899,which wa
作者
张弛
吴海龙
张帅
田振峰
张斌
Zhang Chi;Wu Hailong;Zhang Shuai;Tian Zhenfeng;Zhang Bin(Department of Orthopedics,Shijiazhuang People's Hospital,Hebei Province,Shijiazhuang 050000,China)
出处
《疑难病杂志》
CAS
2024年第4期457-461,共5页
Chinese Journal of Difficult and Complicated Cases
基金
2022年度河北省医学科学研究课题计划项目(20221698)。
关键词
椎体压缩性骨折
骨质疏松性
球囊扩张椎体后凸成形术
再发骨折风险
后凸Cobb's角
骨密度
Ⅰ型前胶原氨基端前肽
预测价值
Vertebral compression fracture,osteoporotic
Balloon dilatation vertebral kyphoplasty
Risk of recurrent fracture
Kyphotic Cobb's angle
Bone mineral density
Type I precollagen amino-terminal pre-peptide
Predictive value
