青少年Ⅰ型神经纤维瘤病性脊柱侧凸患者Cobb角与骨密度的相关性分析

The correlation between Cobb angle and bone mineral density in patients with adolescent neurofibromatosis 1 scoliosis/

中文关键词:  Ⅰ型神经纤维瘤病  脊柱侧凸  青少年  骨密度

英文关键词:Neurofibromatosis 1  Scoliosis  Adolescent  Osteoporosis

中文摘要:

  【摘要】 目的：探讨骨密度与青少年Ⅰ型神经纤维瘤病（neurofibromatosis 1，NF-1）性脊柱侧凸患者Cobb角的关系。方法：NF-1伴脊柱侧凸组共有患者18例，年龄10~18岁，平均14.9岁，侧凸Cobb角40°~132°（平均81.4°）；同年龄非脊柱畸形患者（对照组）25例，年龄11~19岁，平均15.6岁，所有研究对象均行双能X线吸收仪测量非优势侧的股骨近端和腰椎（L2～L4）的骨密度（bone mineral density，BMD），将两组受试者的测量结果进行t检验比较，并对NF-1伴脊柱侧凸组患者的BMD检测结果与侧凸Cobb角进行相关性分析。结果：两组受试者在年龄、性别比例无明显差异（P>0.05），青少年NF-1伴脊柱侧凸患者所测各部位的骨密度均明显低于对照组（P＜0.01），腰椎（L2～L4）平均骨密度（0.61g/cm2）明显低于对照组（1.03g/cm2），腰椎骨密度的降低比股骨明显，NF-1伴脊柱侧凸组患者腰椎及非优势侧股骨近端BMD与侧凸Cobb角无显著性相关（P>0.05）。结论：青少年NF-1伴脊柱侧凸患者存在全身性的骨量减低，其与侧凸的严重程度无关，可能与NF-1伴脊柱侧凸的发病机理有关。

英文摘要:

  【Abstract】 Objective：To evaluate the relationship between bone mineral density（BMD） and the patients with scoliosis secondary to neurofibromatosis 1（NF-1）.Method：18 individuals with adolescent neurofibromatosis 1 scoliosis with mean age of 14.9 years（range，10 to 18 years） and mean Cobb angle of 81.4°（range，40° to 132°） were reviewed retrospectively，while 25 adolescents with mean age of 15.6 years（range，11 to 19 years）undergoing spinal surgery were selected as control.BMD of the lumbar spine（L2-L4） and proximal femur was measured using dual energy X-ray absorptiometry in both groups.BMD in two groups was tested by t-test，and the relationships between BMD of the adolescent neurofibromatosis 1 scoliosis and Cobb angle was assessed using correlation analysis.Result：No age and sex ratio related difference were noted in two groups（P>0.05）.However，the BMD of the lumbar spine and proximal femur in patients who had adolescent neurofibromatosis 1 scoliosis was significantly different from those in control group（P＜0.01），in patients with NF-1，the reduction of BMD in lumbar spine was more remarkable than that in proximal femur.Furthermore，the BMD of the lumbar spine and proximal femur in NF-1 patients had no significant correlations with Cobb angle（P>0.05）.Conclusion：Osteoporosis in patients with adolescent neurofibromatosis 1 scoliosis is not correlative with the severity of the neurofibromatosis 1 scoliosis.However，it may be caused by the inner mechanism.