【摘要】：目的:以MRI為評估手段,比較高位腰椎間盤突出癥患者與正常人的腰椎多裂肌脂肪浸潤程度、面積及厚度,探討高位腰椎間盤突出癥與腰椎多裂肌改變的相關(guān)性。方法:采用回顧性研究方法,選取2012年6月份至2016年12月份在我院脊柱骨病外科住院治療的66例高位腰椎間盤突出癥患者為病例組,其中男性41例,女性25例,年齡為21-64歲。選取在我院體檢的資料齊全健康人66例作為對照組,其中男性41例,女性25例,年齡為24-62歲。選取MRI圖像T2加權(quán)像L1/2、L2/3、L3/4節(jié)段椎間盤平面作為測量平面,應(yīng)用PACS系統(tǒng)測量工具分別測量了不同節(jié)段腰椎多裂肌的總截面積、單純多裂肌截面積、多裂肌厚度,并且評估了雙側(cè)多裂肌的脂肪浸潤程度。以Excel整理和錄入原始數(shù)據(jù)資料,應(yīng)用軟件SPSS 17.0進行統(tǒng)計分析。數(shù)據(jù)計量資料均進行正態(tài)性檢驗,均符合正態(tài)性分布,采用方差分析進行比較,使用均數(shù)±標(biāo)準(zhǔn)差(`X±SD)表示;計數(shù)資料使用卡方分析,用例數(shù)(n)和百分比(%)描述;運用多因素Logistic回歸計算各比值比(odds ratios,OR)和95%可信區(qū)間(confidence intervals,CI)。p0.05認(rèn)為差異有統(tǒng)計學(xué)意義。結(jié)果:卡方分析和方差檢驗顯示,高位腰椎間盤突出癥病人具有年齡大、BMI偏大、總多裂肌截面積減少、總單純多裂肌截面積減少、平均多裂肌厚度較小、脂肪化程度較高的特點,差異均有統(tǒng)計學(xué)意義(P0.05)。多因素logistics回歸分析顯示,年齡的增加、總多裂肌截面積的減少、總單純多裂肌截面積的減少、平均多裂肌厚度降低、脂肪化程度較高均為高位腰椎間盤突出癥的危險因素,差異均有統(tǒng)計學(xué)意義(P0.05)。結(jié)論:腰椎多裂肌的退變與高位腰椎間盤突出癥存在一定的相關(guān)性。高位腰椎間盤突出癥患者多裂肌明顯萎縮,主要表現(xiàn)為多裂肌的面積減小,多裂肌的厚度降低以及多裂肌的脂肪化程度增高。
[Abstract]:Objective: to compare the degree, area and thickness of fat infiltration of lumbar polyfissure muscle between patients with high lumbar disc herniation and normal subjects by MRI, and to explore the correlation between high lumbar disc herniation and changes of lumbar polyfissure muscle. Methods: a retrospective study was conducted in 66 patients with high lumbar disc herniation in our hospital from June 2012 to December 2016, including 41 males and 25 females aged 21-64 years. A total of 66 healthy persons, including 41 males and 25 females aged 24 to 62 years, were selected as control group. The plane of intervertebral disc of L1 / 2 / L2 / 3 / 3 / 4 segment of MRI images was selected as the measuring plane. The total sectional area, the sectional area of pure polyphagus muscle and the thickness of polyfissure muscle were measured by PACS system, respectively. The degree of fat infiltration of bilateral polyfissure muscles was evaluated. Using Excel to sort out and input the original data, the software SPSS 17.0 was used for statistical analysis. The data were tested by normal distribution, and compared with each other by means of ANOVA (mean 鹵standard deviation) (`X 鹵SD), the counting data were described by chi-square analysis, (n) and percentage (%). The ratio (odds ratios,OR) and 95% confidence interval (confidence intervals,CI) were calculated by multivariate Logistic regression. Results: chi-square analysis and variance test showed that the patients with high lumbar disc herniation had older age, larger BMI, less total polyfissure muscle cross-sectional area, less total simple polyfissure muscle cross-sectional area and smaller average polyfissure muscle thickness. Fatty degree of the characteristics of higher, the differences were statistically significant (P0.05). Multivariate logistics regression analysis showed that the increase of age, the decrease of total polyfissure muscle cross-sectional area, the decrease of total pure polyfissure muscle cross-sectional area, the decrease of average polyfissure muscle thickness and the higher degree of fat were all risk factors of high lumbar disc herniation. The difference was statistically significant (P0.05). Conclusion: there is a certain correlation between the degeneration of lumbar polyfissure muscle and high lumbar disc herniation. In the patients with high lumbar disc herniation, the polyfissure muscle shrank obviously, the area of the polyfissure muscle decreased, the thickness of the polyfissure muscle decreased, and the fatty degree of the polyfissure muscle increased.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R681.53

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