青少年Ⅰ型神经纤维瘤病性脊柱侧凸患者的骨密度

The bone mineral density in adolescents with 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  Bone mineral density

中文摘要:

  【摘要】 目的：观察青少年Ⅰ型神经纤维瘤病 （neurofibromatosis 1，NF1）性脊柱侧凸患者的骨密度（BMD）情况，探讨BMD与其脊柱侧凸类型和严重程度的关系。方法：2008年3月～2010年4月收治青少年NF1伴胸椎脊柱侧凸患者23例，按照脊椎有无特征性异常改变分为营养不良性脊柱侧凸组（A组）和非营养不良性脊柱侧凸组（B组），其中A组患者14例，男9例，女5例，年龄10～18岁，平均13.4岁，侧凸 Cobb角60°～132°，平均84.1°；B组9例，男5例，女4例，年龄11～16岁，平均13.2岁，侧凸Cobb角40°～87°，平均71.4°。以同年龄非脊柱畸形志愿者24例为对照组（C组），男16例，女8例，年龄10～17岁，平均14.7岁。所有研究对象均采用双能X线吸收仪测量非优势侧的股骨近端（大转子、股骨颈和Ward′s三角）和腰椎（L2～L4）的BMD，将3组受试者的测量结果进行单因素方差分析（one-way ANOVA），并在A组和B组内对BMD与Cobb角进行Pearson相关分析。结果：3组受试者年龄、性别构成比无统计学差异（P>0.05）。A组与B组Cobb角无统计学差异（P>0.05），A组腰椎及非优势侧股骨近端的BMD与B组相应部位比较均无统计学差异（P>0.05）；A、B两组患者上述各部位的BMD均明显低于C组相应部位（P<0.05），腰椎BMD降低比股骨近端明显。A、B组各部位BMD与Cobb角无显著相关性（P<0.05）。结论：青少年NF1伴营养不良性脊柱侧凸与非营养不良性脊柱侧凸患者均存在骨量下降，但BMD与脊椎是否为营养不良性改变以及侧凸严重程度无关。

英文摘要:

  【Abstract】 Objective：To evaluate the bone mineral density（BMD） in adolescents with scoliosis secondary to neurofibromatosis 1（NF1） and the relationship between BMD and severity and type of scoliosis．Method：From March 2008 to April 2010，23 adolescents suffering NF1 scoliosis were reviewed retrospectively.All cases were divided into 2 groups based on abnormality，14 patients（group A） with dystrophic thoracic scoliosis had the mean age of 13.4 years（range，10 to 18 years） and mean Cobb angle of 84.1°（range，60° to 132°），while 9 patients（group B） with non-dystrophic thoracic scoliosis had the mean age of 13.2 years（range，11 to 16 years） and mean Cobb angle of 71.4°（range，40° to 87°）．Meanwhile，24 volunteers with the mean age of 14.7 years（range，l0 to 17 years） were selected as control（group C）．The BMD of the lumbar spine（L2-L4） and the proximal femur was measured using dual energy X-ray absorptiometry in all cases．BMD was compared among three groups by one-way ANOVA analysis.The relationship between BMD and Cobb angle within group A and group B was assessed using Pearson correlation analysis.Result：No differences in terms of age and sex ratio were noted in three groups（P>0.05）．The Cobb angle and the BMD of the lumbar spine and the proximal femur in group A showed no significant differences compared with group B（P>0.05）．However，both groups A and B showed significant lower BMD than group C（P<0.05），and the diminution of BMD in lumbar spine was more remarkable than that in proximal femur．The values of BMD in group A and B showed no relationship with Cobb angle.Conclusion：The decreased BMD exists in adolescents with dystrophic or non-dystrophic scoliosis secondary to NF1.However，the BMD is not correlative with the type or the severity of scoliosis.