摘要
目的探讨CT骨性影像学参数联合血清骨桥蛋白(OPN)对胸腰椎骨折后方韧带复合体(PLC)损伤的预测价值。方法选取2023年3月至2024年9月章丘区中医医院收治的129例胸腰椎骨折患者进行回顾性分析,根据是否合并PLC损伤分为两组,分别为合并组(n=57)与非合并组(n=72),比较两组CT骨性影像学参数、血清OPN,并进行单因素与多因素logistic回归分析,通过绘制受试者工作特征(ROC)曲线分析CT骨性影像学参数联合血清OPN对PLC损伤的预测价值。结果合并组胸腰椎损伤分类及严重程度(TLICS)>5分占比、OPN水平较非合并组更高(P<0.05),椎弓根间距、局部后凸角、棘突间距、椎体压缩率较非合并组更高(P<0.05);多因素logistic回归分析结果显示,OPN(OR=3.377)、椎弓根间距(OR=2.815)、局部后凸角(OR=2.967)、棘突间距(OR=3.119)、椎体压缩率(OR=3.154)是影响胸腰椎骨折患者PLC损伤的独立危险因素(P<0.05);绘制ROC曲线显示,与单独OPN、椎弓根间距、局部后凸角、棘突间距、椎体压缩率检测相比,联合检测的曲线下面积更高(P<0.05)。结论在胸腰椎骨折患者PLC损伤中,血清OPN呈高水平表达状态,CT骨性影像学检查中椎弓根间距、局部后凸角、棘突间距、椎体压缩率均较高,联合检测能够判断PLC损伤发生情况,具有较高预测价值。
Objective To explore the predictive value of CT bone imaging parameters and serum osteopontin(OPN)for posterior ligament complex(PLC)injury in thoracolum bar vertebral fractures.Methods A retrospective analysis of a total of thoracolumbar vertebral fractures 129 patients who were admitted in Jinan Zhangqiu District Traditional Chinese Medicine Hospital from March 2023 to September 2024 were selected,and they were divided into two groups by whether or not they were combined PLC injuries,namely the combined group(n=57)and the non-combined group(n=72).CT bone imaging parameters and serum OPN were compared in both groups,and univariate analysis and multivariate logistic regression analysis were conducted.The predictive value of CT bone imaging parameters and serum OPN for PLC injuries was analyzed by drawing receiver operating characteristic(ROC)curves of the subjects.Results In comparison of the non-combined group,the account of TLICS>5 score,OPN level of the combined group was higher(P<0.05),the distance between pedicle,local posterior convexity angle,spinous process distance,and vertebral compression rate of the combined group were higher(P<0.05).The results of logistic multivariate analysis showed that OPN(OR=3.377),pedicle distance(OR=2.815),local kyphosis angle(OR=2.967),spinous distance(OR=3.119),and vertebral compression ratio(OR=3.154)were independent risk factors for PLC injury in patients with thoracolumbar fractures(P<0.05).The ROC curve showed that compared with the detection of OPN,pedicle spacing,local kyphosis angle,spinous process spacing,and vertebral compression rate alone,the combined detection had higher area under the curve(P<0.05).Conclusion In patients with thoracolumbar vertebral fractures and PLC injuries,serum OPN is highly expressed.CT bone imaging shows high pedicle distance,local posterior convexity angle,spinous process distance,and vertebral compression rate,the combined detection can determine the occurrence of PLC injuries and have high predictive value.
作者
于本峰
王彬
孙鑫玮
王洪泰
YU Benfeng;WANG Bin;SUN Xinwei;WANG Hongtai(Department of Imaging,Jinan Zhangqiu District Hospital of Traditional Chinese Medicine,Shandong,Jinan 250200,China;Department of Orthopedics,Jinan Zhangqiu District Hospital of Traditional Chinese Medicine,Shandong,Jinan 250200,China)
出处
《中国医药科学》
2025年第15期157-160,共4页
China Medicine And Pharmacy
基金
山东省中医药科技项目(M-2022003)。
关键词
胸腰椎骨折
后方韧带复合体损伤
CT骨性影像学参数
骨桥蛋白
Thoracolumbar spine fracture
Injury to the posterior ligament complex
CT bone imaging parameters
OPN
