本文選題：許莫氏結(jié)節(jié)　切入點：腰椎間盤退變類型　出處：《廣州中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:分析許莫氏結(jié)節(jié)在腰椎MRI中的性別、年齡、位置等分布特點,探討其與腰椎間盤退變類型的相關(guān)性,以提高對許莫氏結(jié)節(jié)發(fā)病機制的認(rèn)識水平。方法:選取2016年9月1日至2016年12月1日期間在廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院接受腰椎MRI檢查的患者781例,記錄其年齡、性別、結(jié)節(jié)發(fā)生部位、結(jié)節(jié)MRI信號類型及其鄰近椎間盤退變類型(正常/膨出/突出/脫出/HIZ/modic改變)等相關(guān)信息,保存患者的影像學(xué)圖像資料,并對其相關(guān)數(shù)據(jù)進行統(tǒng)計分析。結(jié)果:在參與調(diào)查的781(男:376,女:405)例病人中發(fā)現(xiàn)許莫氏結(jié)節(jié)患者93(男性:54,女性:39)例,許莫氏結(jié)節(jié)的發(fā)生率為11.9%；許莫氏結(jié)節(jié)在男性中的發(fā)生率為14.4%,女性9.6%(P0.05),差異有統(tǒng)計學(xué)意義；年齡與許莫氏結(jié)節(jié)無明顯相關(guān)性(P0.05)；許莫氏結(jié)節(jié)多發(fā)于L3椎體上緣(4.1%),其次為L2、L5椎體上緣(3.8%),然后依次為L4椎體下緣(3.7%)、L4椎體上緣(3.6%),差異有統(tǒng)計學(xué)意義；許莫氏結(jié)節(jié)多發(fā)生于上終板(3.3%),下終板的發(fā)生率為2.4%,差異有統(tǒng)計學(xué)意義；93例許莫氏結(jié)節(jié)患者共計465個腰椎間盤節(jié)段,退變255個,許莫氏結(jié)節(jié)在腰椎間盤退變中的發(fā)生率較高(47.8%),差異有統(tǒng)計學(xué)意義,許莫氏結(jié)節(jié)MRI信號類型與腰椎間盤退變無關(guān)；膨出127個,許莫氏結(jié)節(jié)在腰椎間盤膨出中的發(fā)生率較高(48%),差異有統(tǒng)計學(xué)意義,雙側(cè)或單側(cè)終板發(fā)生許莫氏結(jié)節(jié)在腰椎間盤膨出中的發(fā)生率之間的差異無顯著性意義；許莫氏結(jié)節(jié)與腰椎間盤突出、脫出、HIZ無明顯相關(guān)性(P0.05)；modic改變64個,許莫氏結(jié)節(jié)在腰椎modic改變中的發(fā)生率較高(73.4%),差異有統(tǒng)計學(xué)意義。結(jié)論:本組病例腰椎許莫氏結(jié)節(jié)的發(fā)生率男性大于女性,好發(fā)于L2、3椎體上緣、L4椎體上下緣及L5椎體上緣,許莫氏結(jié)節(jié)上終板的發(fā)生率高于下終板；許莫氏結(jié)節(jié)的發(fā)生與腰椎間盤退變、膨出有明顯關(guān)系,并與modic改變密切相關(guān)；
[Abstract]:Objective: to analyze the sex, age and location of Schumo's tubercle in lumbar MRI, and to explore the correlation between it and the type of degeneration of lumbar intervertebral disc. Methods: from September 1st 2016 to December 1st 2016, 781 patients underwent lumbar MRI examination in the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine, and their age and sex were recorded. The location of nodule, the type of MRI signal and adjacent disc degeneration (normal / bulging / protruding / protruding / protruding / protruding / protruding / reproducing / HIZ / modic change) were used to preserve the imaging images of the patients. Results: among the 781 patients (male: 376, female: 405) who participated in the investigation, 93 cases (male: 54, female: 39) with Humo's nodule were found. The incidence of Xu Mo's nodule was 11.9%, the incidence of Xu Mo's nodule in male was 14.4%, the female's rate was 9.6% (P 0.05), the difference was statistically significant. There was no significant correlation between age and Xumo's tubercle (P0.05), Xumo's tubercle was mainly located in the upper margin of L3, followed by L2, L5, 3.8T, and then L4, 3.7C, L4, 3.6T (P < 0.05). Most of the Schumo's nodules occurred in the upper end plate and the inferior end plate. The incidence of the lower end plate was 2.4. The difference was statistically significant in 93 patients with Xu Mo's tubercle with 465 segments of lumbar intervertebral disc, with 255 degeneration. The incidence of Schumo's nodules in lumbar disc degeneration was higher than that in lumbar disc degeneration (47.8%), the difference was statistically significant. The MRI signal type of Xumo's tubercle was not related to the degeneration of lumbar intervertebral disc. The incidence of Xumo's tubercle in lumbar disc herniation was higher than that in control group, the difference was statistically significant, but there was no significant difference between bilateral or unilateral endplates in the incidence of herniation of lumbar intervertebral disc. There was no significant correlation between Xu Mo's tubercle and lumbar disc herniation. There was no significant correlation between Hiz and 64 changes in modic (P 0.05). The incidence of Schumo's nodule in lumbar modic was higher than that in female, and the difference was statistically significant. Conclusion: the incidence of Schumo's tubercle in male is higher than that in female, and it usually occurs in upper and lower margin of L4 and upper edge of L5 vertebra. The incidence of superior end plate of Schumo's tubercle was higher than that of inferior endplate, and the occurrence of Schumo's tubercle was significantly related to lumbar disc degeneration and herniation, and was closely related to the change of modic.
【學(xué)位授予單位】：廣州中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R681.5;R445.2

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