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目的研究体质指数(BMI)在腰椎小关节骨性关节炎(LFOA)发生发展中的影响。方法对佳木斯大学附属第一医院CT室于2013年10月至2015年11月因下腰痛行CT检查的129例患者的临床资料进行回顾性分析。其中男71例,女58例;年龄25~65(50.6±8.3)岁。按照BMI分类方法将患者分成正常组(n=53)、超重组(n=44)和肥胖组(n=32)三组,比较三组患者L1/2~L5/S1节段LFOA(影像学表现为关节间隙狭窄、骨赘形成及骨质变化)的发生率及LFOA分级情况的差异性。统计学分析检验水准取α=0.05,采用χ2检验的分割法时,检验水准调整为α’=0.0125。结果 129例患者共计1 290个腰椎小关节和645椎间盘,415个椎间盘退变(真空征、膨出、突出),占64.3%(415/645);631个腰椎小关节病变,发生率约48.9%(631/1 290)。三组患者性别、年龄差异无统计学意义(P均>0.05)。正常组530个腰椎小关节中238个(44.9%)腰椎小关节病变;超重组440个腰椎小关节中225个(51.1%)腰椎小关节病变;肥胖组320个腰椎小关节中168个(52.5%)腰椎小关节病变。腰椎小关节病变发生率在L4/5最高,占62.8%。LFOA发生率三组间两两比较,正常组分别稍低于超重组、肥胖组,但差异均无统计学意义(P均>0.0125)。LFOA严重度分级随BMI的递增(正常组→超重组→肥胖组)而增高,差异有统计学意义(P<0.05)。结论肥胖是LFOA严重度分级的影响因素,BMI对LFOA的发生率能否获有统计学意义的影响,有待扩大样本量进一步观察。
Objective To study the effect of body mass index (BMI) on the occurrence and development of lumbar facet joint osteoarthritis (LFOA). Methods A retrospective analysis was performed on the clinical data of 129 patients undergoing CT examination of low back pain from October 2013 to November 2015 in the First Affiliated Hospital of Jiamusi University. There were 71 males and 58 females, aged from 25 to 65 (50.6 ± 8.3) years old. The patients were divided into three groups according to BMI classification: normal group (n = 53), overweight group (n = 44) and obesity group (n = 32) Manifested as narrowing of the joint space, osteophyte formation and bone changes) and the classification of LFOA differences. Statistical analysis of test level to take α = 0.05, using χ2 test segmentation method, the test level adjusted to α ’= 0.0125. Results A total of 1290 lumbar facet joints, 645 intervertebral discs and 415 disc degeneration (vacuum signs, bulging and prominent) were found in 129 patients (64.3%, 415/645). The incidence of 631 lumbar facet joints was 48.9 % (631/1 290). Three groups of patients gender, age difference was not statistically significant (P all> 0.05). In the normal group, 238 (44.9%) of the lumbar facet joint lesions were found in 530 lumbar facet joints; 225 (51.1%) of the lumbar facet joint lesions in 440 lumbar facet joints in the overweight group; 168 of 320 lumbar facet joints in the overweight group (52.5 %) Lumbar facet joint disease. The incidence of lumbar facet joint disease was the highest in L4 / 5, accounting for 62.8%. LFOA incidence between the three groups compared with each other, the normal group were slightly lower than the overweight group, obesity group, but the difference was not statistically significant (P> 0.0125). The severity of LFOA grading increased with the increase of BMI (normal group → overweight group → obesity group), the difference was statistically significant (P <0.05). Conclusion Obesity is the influencing factor in the severity of LFOA classification. Whether BMI can affect the incidence of LFOA has a statistical significance, and the sample size needs to be further expanded.