【摘要】：目的:通過對壯族人群膝骨關節(jié)炎患者的臨床癥狀和X線影像進行量化評估,探討壯族人群膝骨關節(jié)炎臨床分級與X線分級、X線測量7組數(shù)據的關系。方法:1.選擇符合膝骨關節(jié)炎診斷標準的壯族患者170例,按照臨床分級標準將病例分成5組,并將其患膝的X線影像按照Kellgren-Lawrence(K/L)分級分為5級。用Spearman分析方法對臨床分級與X線分級的關系進行雙變量相關分析。2.測量170例患者膝關節(jié)X線影像的脛股關節(jié)內側間隙寬度(數(shù)據1)、脛股關節(jié)外側間隙寬度(數(shù)據2)、髕股關節(jié)間隙寬度(數(shù)據3)、脛股關節(jié)內側間室骨贅長度(數(shù)據4)、脛股關節(jié)外側間室骨贅長度(數(shù)據5)、髕股關節(jié)間室骨贅長度(數(shù)據6)、脛股關節(jié)間隙角(數(shù)據7)共7組數(shù)據。用Spearman分析方法對臨床分級與X線測量的7組數(shù)據的關系進行雙變量相關分析。結果:1.臨床分級1-5級例數(shù)分別為1級33例、2級35例、3級42例、4級30例、5級30例。X線K/L分級1-5級例數(shù)分別為1級0例、2級58例、3級58例、4級32例、5級22例。X線K/L分級1、2、3、4、5級與臨床分級1、2、3、4、5級符合程度分別是1級0%、2級29.31%、3級31.04%、4級37.50%、5級72.72%。臨床分級與X線K/L分級呈正相關性,相關系數(shù)r值為0.745,P0.05。2.臨床分級與X線影像測量7組數(shù)據中的數(shù)據1、2、3呈負相關性,數(shù)據4、5、6呈正相關性,數(shù)據7無明顯的相關性。具體如下:(1)臨床分級與脛股關節(jié)內側間隙寬度(數(shù)據1)、脛股關節(jié)外側間隙寬度(數(shù)據2)、髕股關節(jié)間隙寬度(數(shù)據3)呈負相關性,相關系數(shù)r值分別為-0.737、-0.324、-0.496,P均0.05。(2)臨床分級與脛股關節(jié)內側間室骨贅長度(數(shù)據4)、脛股關節(jié)外側間室骨贅長度(數(shù)據5)、髕股關節(jié)間室骨贅長度(數(shù)據6)呈正相關性,相關系數(shù)r值分別為0.560、0.438、0.504,P均0.05。(3)臨床分級與脛股關節(jié)間隙角(數(shù)據7)無明顯相關性,相關系數(shù)r值為0.145,P=0.059。結論:1.壯族人群膝骨關節(jié)炎臨床表現(xiàn)與X線影像的K/L分級呈正相關性;且隨著膝骨關節(jié)炎進展,臨床表現(xiàn)與X線影像的K/L分級吻合度越來越高。2.壯族人群膝骨關節(jié)炎臨床表現(xiàn)與X線影像的脛股關節(jié)內側間隙寬度、脛股關節(jié)內側間室骨贅長度的關系最密切。在臨床X線閱片時,應更加重視脛股關節(jié)內側間隙寬度、脛股關節(jié)內側間室骨贅長度的改變。
[Abstract]:Objective: to evaluate the clinical symptoms and X-ray images of patients with knee osteoarthritis in Zhuang nationality, and to explore the relationship between clinical grade of knee osteoarthritis and X-ray measurement of 7 groups in Zhuang nationality. Method 1: 1. One hundred and seventy Zhuang patients who met the diagnostic criteria of knee osteoarthritis were divided into 5 groups according to the clinical grading criteria. The X-ray images of the affected knees were divided into 5 grades according to the Kellgren-Lawrence (K / L) grade. The relationship between clinical grade and X-ray grade was analyzed by Spearman. 2. 2. The width of medial space of tibiofemoral joint (data 1), the width of lateral space of tibiofemoral joint (data 2), the width of space of patellofemoral joint (data 3) and the length of osteophyte in medial compartment of tibiofemoral joint were measured in 170 patients. The length of osteophyte in the lateral compartment of tibiofemoral joint (data 5), the length of osteophyte in interarticular compartment of patellofemoral joint (data 6) and the angle of tibiofemoral joint space (data 7) were observed in 7 groups. The relationship between clinical grade and 7 groups of X-ray data was analyzed by Spearman. The result is 1: 1. Clinical grade 1-5 cases: 1 33 cases, grade 2 35 cases, grade 3 42 cases, grade 4 cases, grade 5 cases 30 cases. The number of cases of grade 1, grade 2, class 1, grade 3, class 2, grade 2, grade 22 The coincident degree with clinical grade 1 was 0 and 2 with 29.31 and 3 with 31.044 and 37.50 with 5 grade 72.72. There was a positive correlation between clinical grade and X ray K / L grade, the correlation coefficient r value was 0. 745% (P 0. 05.2). There was a negative correlation between clinical grade and X-ray imaging data of 7 groups. There was a positive correlation between clinical grade and X ray imaging data in 7 groups, but there was no significant correlation in data 7. The main results are as follows: (1) the clinical grade was negatively correlated with the width of medial space of tibiofemoral joint (data 1), the width of lateral space of tibiofemoral joint (data 2) and the width of space of patellofemoral joint (data 3). The correlation coefficient r values were -0.737- 0.324- 0.496g P respectively. (2) the clinical grade was positively correlated with the length of medial compartment osteophyte of tibiofemoral joint (data 4), the length of osteophyte of lateral compartment of tibiofemoral joint (data 5), the length of interarticular osteophyte of femoral joint (data 6). The correlation coefficient (r) was 0. 560 ~ 0. 438 ~ 0. 504 (P = 0. 05). (3) there was no significant correlation between clinical grade and tibiofemoral joint space angle (data 7). The correlation coefficient r value was 0. 145 ~ 0. 059. Conclusion 1. The clinical manifestations of knee osteoarthritis in Zhuang nationality were positively correlated with the K / L grade of X-ray images, and with the progression of knee osteoarthritis, the clinical manifestations were more and more consistent with the K / L grade of X-ray images. The clinical manifestation of knee osteoarthritis in Zhuang nationality was most closely related to the width of medial space of tibiofemoral joint and the length of osteophyte in medial compartment of tibiofemoral joint. More attention should be paid to the width of medial space of tibiofemoral joint and the length of osteophyte in medial compartment of tibiofemoral joint.
【學位授予單位】：廣西中醫(yī)藥大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.4

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