| 荆勇芳,任超霞,孙玉娟.OVCF患者 PVP术后再骨折危险因素分析[J].中国烧伤创疡杂志,2025,(4):306~309. |
| DOI： |
| 中文关键词: 经皮椎体成形术 骨质疏松 椎体压缩性骨折 再骨折 危险因素 |
| 英文关键词:Percutaneous vertebroplasty Osteoporosis Vertebral compression fracture Refracture Risk factors |
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| 中文摘要: |
| 【摘要】 目的 探讨骨质疏松性椎体压缩性骨折 (OVCF) 患者经皮椎体成形术 (PVP) 术后再骨折的影响因素。 方法 选取 2021 年 5 月至 2023 年 5 月于郑州市骨科医院进行 PVP 治疗的 96 例 OVCF 患者作为研究对象, 收集患者年龄、体重指数、是否长期应用糖皮质激素等资料, 并根据术后 1 年再骨折发生情况将其分为骨折组和未骨折组, 分析再骨折的危险因素。结果 PVP 术后随访 1 年, 96 例患者再发骨折 17 例 (17.71%), 设为骨折组; 未再发骨折79例 (82.29%), 设为未骨折组。 多因素 Logistic 回归分析结果显示, 体重指数较大、长期应用糖皮质激素、骨折椎体>1 个、骨密度 T 值与骨保护素 (OPG) 水平过低、核因子 κB 受体活化因子配体 (RANKL) 与抗酒石酸酸性磷酸酶-5b (TPACP-5b) 水平过高、骨水泥呈团状弥散、伤椎前缘高度恢复过度或过差是 OVCF 患者 PVP 术后再骨折的独立危险因素 (95%CI 为 1.138～6.312、1.738～8.307、1.017～5.091、0.014～0.132、0.023～0.266、5.308～76.916、4.048～63.933、1.029～4.011、1.287～20.085、1.038～12.025, P= 0.024、P= 0.001、P= 0.045、P<0.001、P< 0.001、P< 0.001、P< 0.001、P = 0.041、P = 0.020、P = 0.043) 。 结论 OVCF 患者体重指数、骨密度 T 值等自身情况以及骨折椎体数、骨水泥弥散状态等骨折与手术情况均能够影响其 PVP 术后再骨折的发生情况。 |
| 英文摘要: |
| 【Abstract】 Objective To study the risk factors for refracture after percutaneous vertebroplasty (PVP) in patients with osteoporotic vertebral compression fractures (OVCF). Methods 96 patients with OVCF who underwent PVP admitted to Zhengzhou Orthopedic Hospital from May 2021 to May 2023 were selected as research subjects. Data of these subjects were collected including age, body mass index, and long-term use of glucocorticoid. Patients were divided into fracture group and non-fracture group based on the occurrence of refracture within 1 year postoperatively to analyze the risk factors for refracture. Results During the follow-up one year after PVP, among the 96 patients, 17 patients (17.71%) suffered from refracture were set as the fracture group, and the other 79 patients (82.29%) without refracture were set as the non-fracture group. Multivariate Logistic regression analysis showed that higher body mass index, long-term use of glucocorticoid, more than one fractured vertebra, lower bone density T-score, lower level of osteoprotegerin (OPG), higher level of receptor activator of nuclear factor-κB ligand (RANKL) and tartrate resistant acid phosphatase-5b (TRACP-5b), bone cement in a clumpy distribution, excessive or poor recovery of height of the anterior edge of the injured vertebrae were independent risk factors for refracture after PVP in OVCF patients (95%CI: 1.138-6.312, 1.738-8.307, 1.017-5.091, 0.014-0.132, 0.023-0.266, 5.308-76.916, 4.048-63.933, 1.029-4.011, 1.287-20.085, 1.038-12.025, P = 0.024, P = 0.001, P= 0.045, P<0.001, P<0.001, P<0.001, P<0.001, P = 0.041, P = 0.020, P = 0.043). Conclusion The occurrence of postoperative refracture after PVP in patients with OVCF is associated with such factors as body mass index, bone density T-score, number of fractured vertebrae, and bone cement distribution. |
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