血清雌二醇、骨密度对绝经后脊柱退行性疾病患者术后预后不良的预测价值OA
Predictive value of serum estradiol and bone mineral density for poor postoperative prognosis in postmenopausal patients with degenerative spinal diseases
目的:探讨血清雌二醇(E2)、骨密度(BMD)对绝经后脊柱退行性疾病患者术后预后不良的预测价值.方法:选取186例行手术治疗的绝经后脊柱退行性疾病患者,根据术后12个月Oswestry功能障碍指数(ODI)评分分为预后良好组(ODI≤20分,112例)和预后不良组(ODI＞20分,74例).比较两组患者临床资料、血清E2水平及腰椎、髋部BMD.采用多因素Logistic回归分析绝经后脊柱退行性疾病患者术后预后不良的影响因素.绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估血清E2、腰椎及髋部BMD对患者术后预后不良的预测价值.结果:两组患者体重指数(BMI)、手术部位、手术时间、术中出血量比较差异无统计学意义(均P＞0.05).与预后良好组比较,预后不良组患者年龄更高,绝经年限更长,手术节段≥3个、复杂术式、术后矢状位垂直轴(SVA)＞50 mm比例升高(均P＜0.05).与预后良好组比较,预后不良组患者血清E2水平降低,腰椎及髋部BMD T值低于预后良好组(均P＜0.05).年龄、手术节段数量、手术方式、术后SVA、血清E2、腰椎BMDT值、髋部BMD T值是绝经后脊柱退行性疾病患者术后预后不良的独立影响因素(均P＜0.05).血清E2、腰椎BMD T值、髋部BMD T值联合预测患者术后预后不良的AUC高于单一指标预测的AUC(均P＜0.05).结论:血清E2、腰椎及髋部BMD是绝经后脊柱退行性疾病患者术后预后不良的影响因素,三者联合检测对患者术后预后不良的预测价值较高.
Objective:To investigate the predictive value of serum estradiol(E2)and bone mineral density(BMD)for poor postoperative prognosis in postmenopausal patients with degenerative spinal diseases.Methods:A to-tal of 186 postmenopausal patients with degenerative spinal diseases who received surgical treatment were enrolled.According to the Oswestry Disability Index(ODI)score at 12 months after surgery,patients were divided into the good prognosis group(ODI≤20 points,112 cases)and the poor prognosis group(ODI＞20 points,74 cases).Clinical data,serum E2 levels,lumbar BMD and hip BMD were compared between the two groups.Multivariate Logistic re-gression analysis was performed to identify the influencing factors of poor postoperative prognosis in postmenopausal patients with degenerative spinal diseases.ROC curves were plotted,and the AUC was calculated to evaluate the pre-dictive value of serum E2,lumbar BMD and hip BMD for poor postoperative prognosis.Results:There were no statis-tically significant differences in body mass index(BMI),surgical site,operation duration and intraoperative blood loss between the two groups(all P＞0.05).Compared with the good prognosis group,patients in the poor prognosis group were older with longer postmenopausal years,and had higher proportions of ≥3 surgical segments,complex surgical procedures and postoperative sagittal vertical axis(SVA)＞50 mm(all P＜0.05).The serum E2 level,lum-bar BMD T-score and hip BMD T-score in the poor prognosis group were significantly lower than those in the good prognosis group(all P＜0.05).Age,number of surgical segments,surgical approach,postoperative SVA,serum E2,lumbar BMD T-score and hip BMD T-score were independent influencing factors for poor postoperative prognosis in postmenopausal patients with degenerative spinal diseases(all P＜0.05).The AUC of combined detection of serum E2,lumbar BMD T-score and hip BMD T-score for predicting poor postoperative prognosis was higher than that of each single indicator(all P＜0.05).Conclusion:Serum E2,lumbar BMD and hip BMD are influencing factors for poor postoperative prognosis in postmenopausal patients with degenerative spinal diseases,and the combined detection of the three indicators exhibits high predictive value for poor postoperative prognosis.
王亚芬;韩桃丽;谢晓聪;姚静;马辉;解国辉
山西医科大学附属运城市中心医院脊柱外科,山西运城 044000山西医科大学附属运城市中心医院脊柱外科,山西运城 044000山西医科大学附属运城市中心医院脊柱外科,山西运城 044000山西医科大学附属运城市中心医院脊柱外科,山西运城 044000山西医科大学附属运城市中心医院脊柱外科,山西运城 044000山西医科大学附属运城市中心医院脊柱外科,山西运城 044000
医药卫生
脊柱退行性疾病绝经后女性雌二醇骨密度预后预测价值
Degenerative spinal diseasesPostmenopausal womenEstradiolBone mineral densityPrognosisPredictive value
《陕西医学杂志》 2026 (8)
1070-1074,5
山西省重点研发计划项目(2023SXZ-12053)
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