摘要
目的探讨高脂血症对胸腰椎骨质疏松性椎体压缩骨折(TOVCF)患者弯角穿刺经皮椎体成形术(PVP)治疗效果的影响。方法回顾性收集平煤神马医疗集团总医院在2019年5月至2021年6月收治的采取弯角穿刺PVP治疗的TOVCF患者的临床资料,首先明确治疗有效和治疗无效的诊断,并采用倾向性评分匹配方法均衡患者一般资料,以1∶1比例匹配有效组和无效组。最终以48例PVP治疗有效的TOVCF患者临床资料纳入有效组,48例PVP治疗无效的TOVCF患者临床资料纳入无效组。由研究者查阅所有患者的临床资料,将可能的影响因素纳入,经logistic回归分析检验找出影响TOVCF患者弯角穿刺PVP治疗效果的相关因素。结果无效组合并高脂血症、有长期糖皮质激素使用史、骨水泥分布为致密型占比高于有效组,术前骨密度T值低于有效组,差异有统计学意义(P<0.05);两组患者年龄、性别、体重指数、伤椎节段、术前Cobb角、麻醉方式、骨水泥推注量进行比较,差异无统计学意义(P>0.05);logistic回归分析结果显示,合并高脂血症、骨水泥分布为致密型占比高是TOVCF患者弯角穿刺PVP治疗效果的危险因素(OR>1,P<0.05),术前骨密度T值高是其保护因素(OR<1,P<0.05)。结论高脂血症可增加TOVCF患者弯角穿刺PVP治疗无效的风险,且骨水泥分布类型、术前骨密度T值是TOVCF患者采取弯角穿刺PVP治疗效果的影响因素。
Objective To investigate the effect of hyperlipidemia on the treatment of thoracolumbar vertebral osteoporotic vertebral compression fracture(TOVCF)by percutaneous vertebroplasty(PVP)with corner puncture.Methods The clinical data on patients with TOVCF who underwent PVP treatment with curved angle puncture admitted to General Hospital of Pingmei Shenma Group between May 2019 and June 2021 were retrospectively collected.Firstly,the diagnosis of effective and ineffective treatment was identified,and the propensity score matching method was used to balance the patient baseline data,matching the effective and ineffective groups in 1∶1 ratio.The clinical data of 48 TOVCF patients with effective PVP treatment were ultimately included in the effective group,while the clinical data of 48 TOVCF patients with ineffective PVP treatment were included in the ineffective group.The researchers consulted the baseline data of all patients and included the possible influencing factors.Logistic regression analysis was used to find out the relevant factors affecting the therapeutic effect of corner puncture PVP for TOVCF patients.Results The proportion of ineffective combination with hyperlipidemia,long-term history of glucocorticoid use,dense bone cement distribution were higher than that of the effective group,and the preoperative bone mineral density T value was lower than that of the effective group(P<0.05).There were no statistical significant differences between the two groups in age,sex,body mass index,injured vertebral segment,Cobb angle before operation,mode of anesthesia and amount of bone cement injection(P>0.05).Logistic regression analysis showed that the combination of hyperlipidemia and the high proportion of dense bone cement distribution were the risk factors for TOVCF patients to take corner puncture PVP treatment(OR>1,P<0.05),and the high preoperative bone mineral density T value was the protective factor(OR<1,P<0.05).Conclusion Hyperlipidemia can increase the risk of ineffectiveness of angle puncture PVP treatment in patients with TOVCF,and the distribution type of bone cement and preoperative bone mineral density T value are the influencing factors for the effect of angle puncture PVP treatment in patients with TOVCF.
作者
杨红杰
刘帅
董胜利
张豪伟
YANG Hongjie;LIU Shuai;DONG Shengli;ZHANG Haowei(Department of Spinal Surgery,General Hospital of Pingmei Shenma Group,Pingdingshan 467000,China)
出处
《河南医学研究》
2023年第23期4332-4336,共5页
Henan Medical Research
关键词
骨质疏松性椎体压缩骨折
高脂血症
经皮椎体成形术
osteoporotic vertebral compression fracture
hyperlipidemia
percutaneous vertebroplasty
