| 潘福敏,王善金,麻彬,赵卫东,吴德升.围绝经期女性腰椎椎间盘退变程度的MRI观察[J].脊柱外科杂志,2016,14(5):297-300. |
围绝经期女性腰椎椎间盘退变程度的MRI观察  点此下载全文 (Fulltext) |
| 潘福敏 王善金 麻彬 赵卫东 吴德升 |
| 同济大学附属东方医院脊柱外科, 200120 上海 |
| 基金项目：同济大学青年优秀人才培养行动计划资助（2013KJ075）浦东新区卫生系统重点学科建设资助（PWZx2014-02） |
| DOI：10.3969/j.issn.1672-2957.2016.05.009 |
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| 摘要： |
| 目的 探讨围绝经期女性腰椎椎间盘MRI特点及相关退变规律。方法 随机选择2014年1月-12月来本院就诊的成年男女患者各420例，记录患者年龄、身高、体质量指数（BMI）、吸烟史、高血压史、糖尿病史、月经史、职业等，每位患者均行腰椎MRI检查。女性患者按照月经史分为5个组：绝经前组（n=76），绝经>0年且<6年组（n=98），绝经≥6年且< 11年组（n=82），绝经≥11年且≤15年组（n=80），绝经>15年组（n=84）。用Pfirrmann分级系统对腰椎椎间盘退变程度进行分级，用SPSS 19.0软件进行相关数据分析。结果 男女患者年龄、BMI、糖尿病史、高血压史、职业等差异无统计学意义（P>0.05）；男性吸烟率明显高于女性，差异有统计学意义（P<0.05）。男性患者Pfirrmann分级≥Ⅲ级的椎间盘比例高于女性（男78.2%，女60.8%），差异有统计学意义（P<0.05）；Pfirrmann Ⅳ、Ⅴ级时差异更显著。在女性亚组中，绝经前组各椎间盘水平Pfirrmann平均分均显著低于各绝经组，差异有统计学意义（P<0.05）。绝经≤15年时，绝经年限越高，L1/L2、L2/L3、L4/L5及L5/S1椎间盘Pfirrmann平均分越高，差异有统计学意义（P<0.05）；绝经≥11年且≤15年组与绝经>15年组间各节段椎间盘Pfirrmann平均分差异均无统计学意义（P>0.05）。结论 男性患者腰椎椎间盘退变较女性严重。绝经后女性腰椎椎间盘退变较绝经前严重，且在绝经≤15年时，绝经年限越长，退变越严重；绝经>15年后，腰椎椎间盘退变进程减缓。因此，雌激素水平下降可能是腰椎椎间盘退变的危险因素。 |
| 关键词：腰椎 椎间盘退行性变 骨质疏松 绝经后 雌激素类 磁共振成像 |
| MRI characteristics of lumbar disc degeneration in perimenopausal women Fulltext |
| PAN Fu-min WANG Shan-jin MA Bin ZHAO Wei-dong WU De-sheng |
| Department of Spinal Surgery, East Hospital, Tongji University, Shanghai 200120, China |
| Fund Project: |
| Abstract: |
| Objective To explore the MRI characteristics of lumbar intervertebral discs degeneration in perimenopausalwomen. Methods From January 2014 to December 2014,420 female and 420 male patients were chosen randomly because of low back pain. Demographic data including age,height,body mass index(BMI),diabetes history,hypertension history,smoking history,menstrual history and careers were collected. The female patients were divided into 5 subgroups according to menstrual histories:pre-menopause, menopause > 0 year and < 6 years,menopause ≥6 years and < 11 years,menopause ≥11 years and ≤15 years and menopause >15 years. Each patient underwent a lumbar MRI and degeneration of the disc was graded by the Pfirrmann grading system. The data was analyzed by SPSS 19.0 system. Results Age,BMI,diabetes mellitus,hypertension history and careers showed no statistical significance between the male and female patients(P<0.05). The smoking rate of males was significantly higher than the females,and the difference was statistically significant(P<0.05). The male patients showed higher disc proportion in Pfirrmann ≥grade Ⅲ than the females,and the difference was statistically significant(P<0.05);in Pfirrmann grade Ⅳ and Ⅴ,difference was more significant(P<0.05). The pre-menopause group showed lower mean Pfirrmann scores than the menopause groups,and the difference was statistically significant(P<0.05). The mean Pfirrmann scores of L1/L2,L2/L3,L4/L5 and L5/S1 were increased in menopause ≤15 years group, and the differences were statistically significant(P<0.05). However,the mean Pfirrmann scores showed no difference between the menopause ≥11 years and ≤15 years group and menopause >15 years group. Conclusion Males would have more severe lumbar disc degeneration than females. In females,the degeneration worsen with an increase of menopause years. Furthermore,the degeneration may be stable when menopause is >15 years. Therefore,the decline in estrogen levels may be a risk factor for lumbar disc degeneration. |
| Keywords:Lumbar vertebrae Intervertebral disc degeneration Osteoporosis Postmenopausal Estrogens Magnetic resonance imaging |
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