本文選題：骨質(zhì)疏松性椎體壓縮性骨折 + 骨密度��； 參考：《中國骨質(zhì)疏松雜志》2017年02期

【摘要】：目的探討骨質(zhì)疏松性椎體壓縮性骨折(OVCF)患者椎體后凸成形術(shù)(PKP)后發(fā)生再骨折的影響因素,分析骨密度(BMD)對預(yù)測骨折再發(fā)的臨床價值。方法前瞻性的隊(duì)列研究納入我院208例確診的OVCF并行PKP手術(shù)的患者,初次骨折時檢測患者骨密度值(BMD)并記錄相關(guān)臨床資料,術(shù)后隨訪2年以上,以患者骨折再發(fā)為隨訪終點(diǎn)事件。采用KaplanMeier分析及多元Cox回歸模型進(jìn)行骨折再發(fā)的危險因素分析,受試者工作特征(ROC)曲線用于評估BMD對骨折再發(fā)的預(yù)測價值。結(jié)果 208例OVCF患者PKP術(shù)后2年內(nèi)出現(xiàn)骨折再發(fā)共37例(17.8%)。Cox回歸分析顯示性別、BMD值以及初次雙節(jié)段骨折是患者骨折再發(fā)的獨(dú)立危險因素。以BMD為預(yù)測標(biāo)準(zhǔn),ROC曲線下面積為0.787,診斷臨界點(diǎn)為-3.0SD,靈敏度及特異度分別為83.2%和66.8%。Kaplan-Meier分析結(jié)果示BMD-T值-3.0 SD的OVCF患者PKP術(shù)后骨折再發(fā)率較BMD-T值-3.0 SD更高(P=0.024)。結(jié)論骨密度對OVCF患者PKP術(shù)后骨折再發(fā)的風(fēng)險具有重要評估價值,尤其對于BMD-T值≤-3.0SD者,在行PKP術(shù)時應(yīng)充分考慮到其術(shù)后骨折再發(fā)的高風(fēng)險性。
[Abstract]:Objective to investigate the influencing factors of refracture after kyphoplasty and PKP in patients with osteoporotic vertebral compression fracture (OVCF), and to analyze the clinical value of bone mineral density (BMD) in predicting the recurrence of fracture. Methods A prospective cohort study was conducted in 208 patients with OVCF undergoing PKP operation in our hospital. Bone mineral density (BMD) was measured at the first time of fracture and the clinical data were recorded. The patients were followed up for more than 2 years. The recurrence of fracture was regarded as the end point of follow-up. KaplanMeier analysis and multivariate Cox regression model were used to analyze the risk factors of recurrence of fracture. The operating characteristics of subjects were used to evaluate the predictive value of BMD for recurrence of fracture. Results among the 208 patients with OVCF, the recurrence of fracture occurred within 2 years after PKP in 37 cases. The regression analysis showed that sex and double segment fracture were independent risk factors for the recurrence of fracture. The area under BMD curve was 0.787, the critical point of diagnosis was -3.0 SD.The sensitivity and specificity were 83.2%. The results of 66.8%.Kaplan-Meier analysis showed that the recurrence rate of OVCF patients with BMD-T value -3.0 SD was higher than that of BMD-T value -3.0 SD. Conclusion BMD has important value in evaluating the risk of recurrence of fracture after PKP in patients with OVCF, especially in patients with BMD-T 鈮，

本文編號：1966878