PLos One:MRI的骨水肿与强直性脊柱炎的低骨密度高度相关

2017-12-16 xiangting MedSci原创

低骨密度在AS患者中很常见。MRI上的BME与脊柱、股骨的低骨密度高度相关。

这项研究旨在评估强直性脊柱炎(AS)患者磁共振成像(MRI)上的骨髓水肿(BME)和骨密度(BMD)之间的关系。

这项研究纳入333例AS患者,这些患者接受BMD测量和轴位MRI检查。另外还纳入了106例正常对照。修改的纽约标准被用作AS的分类标准。收集并分析临床、实验室和影像学数据。使用双能X线吸收测定法评估腰椎和股骨近端的BMD。低BMD定义为Z评分≤-2。使用加拿大脊柱关节炎研究联盟(SPARCC)MRI指数来评估骶髂关节(SIJ)和脊柱的炎症。

333例患者中,男女比例为4.6:1,平均年龄为28.5±10.6岁,平均病程为7.3±6.8年。AS患者的低BMD、骨量减少和骨质疏松的患病率明显高于对照组(分别为19.8%,62.8%和5.7% vs.4.7%,33.0%和0%,P = 0.000)。MRI上有BME患者的BMD值显著较低,脊柱和股骨低BMD的患病率明显高于无BME患者。多因素Logistic回归分析显示男性(OR 3.87,95%CI 1.21-7.36,P = 0.023),ASDAS-CRP评分高(OR 2.83,95%CI 1.36-4.76,P = 0.015),骶髂关节MRI上有BME(OR 2.83,95%CI 1.77-6.23,P= 0.000)和脊柱MRI(OR 4.06,95%CI 1.96-8.46,P = 0.000)和高度骶髂关节炎(OR 2.93,95%CI 1.82-4.45,P = 0.002)是低BMD的危险因素。SIJ的SPARCC评分与股骨BMD呈负相关(r = -0.22,95%CI -0.33至-0.10,P = 0.000)。此外,脊柱SPARCC评分与BMD值(r = -0.23,95%CI -0.36至-0.09,P = 0.003)和Z评分(r = -0.24,95%CI -0.36至0.12,P = 0.001)呈负相关。

低骨密度在AS患者中很常见。MRI上的BME与脊柱、股骨的低骨密度高度相关。

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    2018-05-11 zywlvao
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    2017-12-18 小华子
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中华医学会第十六届骨科学术会议暨第九届COA国际学术大会于2014年11月20~23日在北京国家会议中心隆重召开。广西医科大学第一附属医院吴昊医生作了研究报告,内容:一期前路手术治疗强制性脊柱炎下颈椎骨折脱位。 韧带、纤维环骨化而使脊柱的弹性和韧性显著降低。AS患者发生脊柱骨折的危险性比正常人高3.5倍。AS患者颈椎骨折同时累及三柱,且更易伴发脱位。前路手术的优点:手术体位摆放简单;显露