摘要
目的:探讨骨钙素(BGP)、Ⅰ型前胶原N端前肽(PⅠNP)联合多层螺旋CT(MSCT)定量参数对骨质疏松性椎体压缩骨折(OVCF)术后复发的预测价值。方法:选取2020年12月至2022年2月青岛大学附属青岛市第三人民医院行经皮椎体后凸成形术的OVCF患者168例,并根据术后随访是否复发分为复发组62例和未复发组106例。术前行酶联免疫吸附法(ELISA)检测患者血清BGP、PⅠNP,行MSCT收集患者的骨体积分数(BV/TV)、骨小梁厚度(Tb.Th)、骨小梁间隙(Tb.Sp)、结构模型指数(SMI)。比较两组患者的相关临床资料,BGP、PⅠNP和MSCT定量参数,采用logistic回归分析患者术后复发的影响因素。采用受试者工作特征(ROC)曲线分析BGP、PⅠNP、MSCT定量参数对患者术后复发的预测价值。结果:复发组患者骨水泥渗漏率、BGP、PⅠNP、Tb.Sp、SMI高于无复发组;复发组患者术后进行抗骨质疏松治疗比例、BV/TV、Tb.Th低于无复发组(P均<0.05)。多因素logistic回归分析结果显示BGP、PⅠNP、Tb.Sp、SMI是患者术后复发的危险因素,BV/TV、Tb.Th是患者术后复发的保护因素(P均<0.05)。ROC分析显示血清BGP、PⅠNP、BV/TV、Tb.Sp、Tb.Th、SMI及联合预测的曲线下面积(AUC)分别为0.930、0.836、0.837、0.741、0.805、0.782、0.960;AUC比较结果显示,联合预测优于单独预测(Z=3.892、4.006、3.793、5.561、4.557、5.003,P均<0.05)。结论:BGP、PⅠNP联合MSCT定量参数可能对OVCF术后复发具有较高的预测价值,可为临床患者术后复发预测提供参考依据。
Objective:To investigate the predictive value of quantitative parameters of osteocalcin(BGP)and procollagenⅠN-terminal peptide(PⅠNP)combined with multi-slice spiral CT(MSCT)for the postoperative recurrence of osteoporotic vertebral compression fracture(OVCF).Methods:A total of 168 patients with OVCF who underwent percutaneous kyphoplasty(PKP)at the Affiliated Qingdao Third People's Hospital of Qingdao University from December 2020 to February 2022.Patients were divided into a recurrence group(62 cases)and a non-recurrence group(106 cases)based on postoperative follow-up results.Enzyme-linked immunosorbent assay(ELISA)was performed to detect serum BGP and PⅠNP in patients before surgery,and MSCT was used to collect bone volume fraction(BV/TV),trabecular bone thickness(Tb.Th),trabecular bone gap(Tb.Sp),and structural model index(SMI).Clinical data,along with BGP,PⅠNP and MSCT quantitative parameters were compared between two groups,and logistic regression analysis was used to identify the influencing factors of postoperative recurrence.The receiver operating characteristic(ROC)curves were employed to assess the predictive value of the BGP,PⅠNP,and MSCT quantitative parameters for postoperative recurrence.Results:The recurrence group had higher rate of bone cement leakage,elevated levels of BGP,PⅠNP,increased Tb.Sp,and SMI compared to the non-recurrence group,the recurrence group also had a lower proportion of postoperative anti-osteoporosis treatment,and a lower BV/TV and Tb.Th(all P<0.05).Multivariate logistic regression analysis revealed that BGP,PⅠNP,Tb.Sp,and SMI were risk factors for postoperative recurrence,while BV/TV and Tb.Th were protective factors(all P<0.05).ROC analysis showed that the areas under the curve(AUC)for serum BGP,PⅠNP,BV/TV,Tb.Sp,Tb.Th,SMI and their combined prediction were 0.930,0.836,0.837,0.741,0.805,0.782,and 0.960,respectively.AUC comparison revealed that the combined prediction was superior to the individual prediction(Z=3.892,4.006,3.793,5.561,4.557,and 5.003;all P<0.
作者
陶海涛
杨骐睿
刘太璞
夏厚栋
程明国
杨昱
TAO Haitao;YANG Qirui;LIU Taipu;XIA Houdong;CHENG Mingguo;YANG Yu(Department of Orthopaedics,the Affiliated Qingdao Third People's Hospital of Qingdao University,Qingdao 266000,China;Clinical Major of Xinjiang Medical University,Urumqi 830054,China;Department of Radiology,the Affiliated Qingdao Third People's Hospital of Qingdao University,Qingdao 266000,China)
出处
《中华骨与关节外科杂志》
CSCD
北大核心
2024年第12期1063-1068,共6页
Chinese Journal of Bone and Joint Surgery
基金
青岛市医药卫生科研指导项目(2022-WJZD105)。
关键词
骨钙素
Ⅰ型前胶原N端前肽
多层螺旋CT
骨质疏松性椎体压缩骨折
术后复发
Osteocalcin
ProcollagenⅠN-terminal Propeptide
Multi-slice Spiral CT
Osteoporotic Vertebral Compression Fracture
Postoperative Recurrence
