CAJ | 학술논문

目的评估中国南方都市人群中腰椎间盘退行性变化的程度、发生率及在不同椎间节段的分布状况.方法共有1 724例志愿者参加了该研究,男662例,女1062例;年龄18～85岁,平均为38.04岁.对所有参加者进行了影像学检查、临床体格检查和症状学评分.采用1.5 T的磁共振系统进行脊柱扫描(腰椎T2矢状位序列成像).在所得MR图像的基础上对腰椎间盘退变进行评分.评估每个腰椎节段的许莫氏结节(Schmorl nodes)、高信号区(HIZ)和骨髓信号的改变.结果许莫氏结节的发生与性别相关,许莫氏结节在男性中发生率更高.卡方检验结果显示许莫氏结节、骨髓信号改变和高信号区三种影像学表现与腰椎间盘退变的相关性依次增强,均有统计学意义.高信号区和骨髓信号改变与年龄呈明显相关.许莫氏结节和高信号区在腰椎中的分布规律为:许莫氏结节自上(头端)至下(尾端)呈降序分布;椎间盘高信号区自上至下呈升序分布.腰椎间盘退变评分(DDD分数)与身体质量指数呈正相关.DDD评分结果在男女性别间无明显差异.腰椎间盘节段自上(头端)至下(尾端)的退变发生呈持续升高趋势.腰椎间盘退变在男女性别之间有一定程度的差异.腰椎间盘退变在年轻人群中总体发生率高,男性为35.3％,女性为33.9％.结论腰椎间盘退变在中国南方人群呈高发状态,特别是年轻成人,25～35岁的男性比女性更易患腰椎间盘退变,身体质量指数与腰椎间盘退变明显相关.
목적 평고중국남방도시인군중요추간반퇴행성변화적정도、발생솔급재불동추간절단적분포상황.방법 공유1 724례지원자삼가료해연구,남662례,녀1062례;년령18～85세,평균위38.04세.대소유삼가자진행료영상학검사、림상체격검사화증상학평분.채용1.5 T적자공진계통진행척주소묘(요추T2시상위서렬성상).재소득MR도상적기출상대요추간반퇴변진행평분.평고매개요추절단적허막씨결절(Schmorl nodes)、고신호구(HIZ)화골수신호적개변.결과 허막씨결절적발생여성별상관,허막씨결절재남성중발생솔경고.잡방검험결과현시허막씨결절、골수신호개변화고신호구삼충영상학표현여요추간반퇴변적상관성의차증강,균유통계학의의.고신호구화골수신호개변여년령정명현상관.허막씨결절화고신호구재요추중적분포규률위:허막씨결절자상(두단)지하(미단)정강서분포;추간반고신호구자상지하정승서분포.요추간반퇴변평분(DDD분수)여신체질량지수정정상관.DDD평분결과재남녀성별간무명현차이.요추간반절단자상(두단)지하(미단)적퇴변발생정지속승고추세.요추간반퇴변재남녀성별지간유일정정도적차이.요추간반퇴변재년경인군중총체발생솔고,남성위35.3％,녀성위33.9％.결론 요추간반퇴변재중국남방인군정고발상태,특별시년경성인,25～35세적남성비녀성경역환요추간반퇴변,신체질량지수여요추간반퇴변명현상관.
Objective To estimate the extent,prevalence and distribution of degenerative changes of lumbar disc and some spinal structural abnormalities in a population of southern China.This study also determined the variation of these abnormalities in different age and gender groups.Methods A total of 1,724 southern Chinese volunteers between 18 and 85 years of age were recruited by open invitation.Radiologic examinations,clinical interviews and physical examinations were administered to all the participants.T2-weighted MRI sequences of the whole spine were obtained.On MRIs,disc degeneration was scored using our new methods.Schmorl nodes,high intensity zones,and marrow changes were assessed for each lumbar segment.Results There was a significant trend for an overall association between Schmorl nodes and gender (higher in men).In chi-square test,Schmorl nodes,marrow changes and HIZ showed a significant positive association with LDD.HIZ and marrow changes showed significant association with age.The distributive sequence of the Schmorl nodes in lumbar decreased from upper to lower,but HIZ was in a reverse order in disc levels.DDD scores showed a significant positive association with BMI.We found no significant difference in D)DD scores between genders.Among the different areas of degeneration,there was a consistent increase in prevalence of LDD from upper to lower disc levels.There were some variations in LDD across sex groups.The prevalence of LDD in younger was high (35.3％ in men and 33.9％ in women).Conclusion Schmorl nodes differed greatly between genders and were not age-related.A high prevalence of LDD existed in this southern Chinese sample.BMI was found to be correlated with LDD.In young adults,degenerative disc findings were relatively common.Men aged 25 to 35 years were more likely to have LDD than women,which we presumed to be due to environmental factors.