MSCT定量技术在体操运动员桡骨远端骨折康复效果中的评估价值及与骨代谢的相关性

doi:10.7517/issn.1674-0475.220803

摘要/Abstract

摘要： 本文目的是探究多层螺旋CT(MSCT)定量技术评估体操运动员桡骨远端骨折康复效果中的价值及MSCT定量参数与骨代谢的相关性。选取86例体操运动员桡骨远端骨折患者,均行保守治疗,治疗后3个月评估腕关节康复效果。结果显示,康复不良者治疗后3个月血清碱性磷酸酶(ALP)、骨钙素(BGP)、骨保护素(OPG)水平均低于康复良好者(P＜0.05);康复不良者治疗前、治疗后3个月MSCT定量参数骨折端力学强度指数(BSI)、皮质骨骨密度(cBMD)及ΔBSI、ΔcBMD均低于康复良好者(P＜0.05);治疗后3个月BSI、cBMD与血清ALP、BGP、OPG水平呈正相关(P＜0.05);ΔBSI、ΔcBMD与康复效果呈正相关(P＜0.05);ΔBSI、ΔcBMD联合评价康复效果为不良的曲线下面积(AUC)为0.934。MSCT定量参数与体操运动员桡骨远端骨折患者骨代谢水平密切相关,且在评估康复效果中具有良好价值。

关键词: 体操运动员, 桡骨远端骨折, 多层螺旋CT, 康复效果, 骨代谢

Abstract: The objective of this paper was to explore the evaluation value of multi-slice spiral CT (MSCT) quantitative technology in the rehabilitation effect of distal radius fractures in gymnasts and its correlation with bone metabolism. Eighty-six patients with distal radius fractures of gymnasts were selected, all of them underwent conservative treatment. The rehabilitation effect of wrist joint was evaluated 3 months after treatment. The results showed that the levels of serum alkaline phosphatase (ALP), osteocalcin (BGP), and osteoprotegerin (OPG) in patients with poor recovery were lower than those in patients with good recovery 3 months after treatment (P<0.05). Before treatment and 3 months after treatment, MSCT quantitative parameters of fracture end mechanical strength index (BSI), cortical bone mineral density (cBMD), ΔBSI and ΔcBMD in patients with poor recovery were lower than those in patients with good recovery (P＜0.05). Three months after treatment, BSI and cBMD were positively correlated with serum ALP, BGP and OPG levels (P＜0.05). ΔBSI and ΔcBMD were positively correlated with rehabilitation effect (P＜0.05). The area under the curve (AUC) of poor rehabilitation effect assessed by ΔBSI and ΔcBMD was 0.934. It can be seen that the quantitative parameters of MSCT are closely related to the level of bone metabolism in patients with distal radius fractures in gymnasts, and have a good value in evaluating the rehabilitation effect.

Key words: gymnast, distal radius fracture, multi-slice spiral CT, rehabilitation effect, bone metabolism

郜研, 陈晓磊. MSCT定量技术在体操运动员桡骨远端骨折康复效果中的评估价值及与骨代谢的相关性[J]. 影像科学与光化学, 2022, 40(6): 1519-1523.

GAO Yan, CHEN Xiaolei. The Evaluation Value of MSCT Quantitative Technique in the Rehabilitation of Distal Radius Fractures in Gymnasts and Its Correlation with Bone Metabolism[J]. IMAGING SCIENCE AND PHOTOCHEMISTRY, 2022, 40(6): 1519-1523.

参考文献

[1] Campbell R A, Bradshaw E J, Ball N B, et al. Injury epidemiology and risk factors in competitive artistic gymnasts:A systematic review[J]. British Journal of Sports Medicine, 2019, 53(17):1056-1069.
[2] Wolf M R, Avery D, Wolf J M. Upper extremity injuries in gymnasts[J]. Hand Clinics, 2017, 33(1):187-197.
[3] Chung K C. The contemporary view of distal radius fracture management[J]. Hand Clinics, 2021, 37(2):xiii.
[4] 王俊鹏, 刘春光. 多层螺旋CT图像重建在老年桡骨远端骨折患者分型诊断中的价值分析[J]. 实用医技杂志, 2021, 28(12):1451-1454.
[5] 成艳平, 赵虎. 多层螺旋CT三维重建在脊椎骨折诊断中的应用价值[J]. 影像科学与光化学, 2020, 38(2):200-205.
[6] Yang W H, Wang F. Multislice spiral computed tomography postprocessing technology in the imaging diagnosis of extremities and joints[J]. Computational & Mathematical Methods in Medicine, 2021, 2021(1):9533573.
[7] 张红艳, 陈文. 定量CT评价低强度超声仪促进桡骨远端骨折愈合效果的临床分析[J]. 现代仪器与医疗, 2020, 26(6):46-49.
[8] 陈孝平, 汪建平. 外科学[M]. 8版. 北京:人民卫生出版社, 2013:659-661.
[9] 冯延冰, 李刚. X线平片与MSCT三维重建在桡骨远端骨折诊断中的价值分析[J]. 中国CT和MRI杂志, 2022, 20(3):174-176.
[10] 冯万立, 王小明, 陈广儒, 等. 补肾健骨汤联合夹板外固定治疗桡骨远端骨折的临床效果及对骨折愈合、骨代谢指标的影响[J]. 解放军医药杂志, 2020, 32(11):94-97.
[11] 欧锐金, 谭建基, 唐灿锐, 等. 锁定钢板内固定在桡骨远端骨折中的应用效果及对骨代谢状态的影响研究[J]. 中国医学创新, 2019, 16(18):19-22.
[12] 吴清英. 超声波联合牵引治疗对跳水运动员腰椎间盘突出症的疗效观察[J]. 中国体育科技, 2018, 54(2):121-124.
[13] 梁梅, 邹光成, 梁宏. 多层螺旋CT图像重建在老年桡骨远端骨折患者诊断分型中的价值分析[J]. 影像研究与医学应用, 2020, 4(13):54-55.
[14] 张世琳, 王明威. 多层螺旋CT后处理技术在四肢骨关节骨折影像诊断中的意义分析[J]. 影像研究与医学应用, 2022, 6(1):85-87.
[15] 王姿幻, 辛宏, 崔卓, 等. 沈阳汉族医学生骨强度指数和体成分变化及相关性分析[J]. 中国骨质疏松杂志, 2018, 24(8):1054-1059.
[16] 段久明, 张奎, 汪灵远. 定量CT评价低强度超声仪促进桡骨远端骨折愈合效果及价值分析[J]. 中国医药导报, 2013, 10(23):70-71, 74.
[17] 江继君, 刘兴坤, 董霞, 等. 桃红四物汤对桡骨远端骨折患者腕关节功能及骨代谢的影响[J]. 中医药学报, 2021, 49(4):69-73.
[18] 李炎, 常军英, 穆卫庐, 等. 老年女性桡骨远端骨折患者的骨代谢指标检测分析及再发骨折的危险因素探讨[J]. 中国医药导报, 2019, 16(30):89-92.
[19] Chen Z N, Xie L L, Xu J, et al. Changes in alkaline phosphatase, calcium, C-reactive protein, D-dimer, phosphorus and hemoglobin in elderly osteoporotic hip fracture patients[J]. Annals of Palliative Medicine, 2021, 10(2):1079-1088.
[20] Fusaro M, Gallieni M, Aghi A, et al. Osteocalcin (bone GLA protein) levels, vascular calcifications, vertebral fractures and mortality in hemodialysis patients with diabetes mellitus[J]. Journal of Nephrology, 2019, 32(4):635-643.
[21] Wu S W, Li Z Y, Zhang J, et al. The genetic association between osteoprotegerin gene polymorphisms and fracture risk in Chinese Han population[J]. Journal of Cellular Physiology, 2019, 234(11):20603-20607.