吸烟与腰椎间盘退变的相关性

The relationship between smoking and lumbar disc degeneration

中文关键词:  腰椎间盘退变  吸烟  腰痛

英文关键词:Lumbar discs degeneration  Smoking  Low back pain

中文摘要:

  【摘要】 目的：探讨吸烟与腰椎间盘退变程度的相关性。方法：随机选择2014年1月~2014年12月因腰痛在我院脊柱外科门诊就诊的200例成年男性患者，详细问诊患者年龄、身高、体重、糖尿病史、高血压史、饮酒史、吸烟史、职业等一般情况，根据吸烟史将患者分为吸烟组与非吸烟组，每例患者行腰椎MRI检查，用Pfirrmann分级系统对各节段腰椎间盘进行分级，用VAS量表对患者腰痛程度评分，用SPSS 19.0分析吸烟与腰椎间盘退变及腰痛程度的相关性。结果：两组患者一般资料无显著性差异（P>0.05）。吸烟组Pfirrmann分级为4、5级的椎间盘比例高于非吸烟组（P<0.05）。在L1/2水平分级为2级、4级、5级，在L2/3水平分级为2级、4级，在L3/4水平分级为2级、3级、4级、5级，在L4/5水平分级为3级、4级，在L5/S1水平分级为3级、5级的椎间盘比例，两组间有显著性差异（P<0.05）。在吸烟组中，Pfirrmann分级为4、5级的椎间盘比例在L1/2、L2/3水平高于L4/5、L5/S1水平，且有显著性差异（P＜0.05）。吸烟组腰痛VAS评分（5.00±1.30）高于非吸烟组（4.06±2.41），且有显著性差异（P<0.05）。结论：吸烟加剧腰椎间盘退变，且吸烟会加重患者腰痛程度。另外，吸烟对上腰椎间盘的影响大于下腰椎间盘。

英文摘要:

  【Abstract】 Objectives: To discuss the relationship between smoking and lumbar disc degeneration(LDD). Methods: 200 adult male patients in our spine clinic for the first time due to low back pain from January 2014 to December 2014 were selected. The demographic data including age, height, weight, diabete history, high blood pressure history, alcohol addict history, smoking history and career were collected. The patients were divided into two groups according to their smoking history. Each patient had a lumbar MRI scan and patients with lumbar trauma, infection, tumor and deformity were excluded. Each level of the discs was graded by the Pfirrmann grading system, and the severity of low back pain was graded by the VAS score. The data were analyzed by SPSS 19.0. Results: Demographic data like age, body mass index(BMI), diabete history, high pressure history and alcohol addict history showed no differences between the two groups(P>0.05). In Pfirrmann 4 and 5, the smoking group showed higher disc number proportions than the non-smoking group(P<0.05). The two groups showed significant differences in Pfirrmann 2, 4, 5 in L1/2, Pfirrmann 2, 4 in L2/3, Pfirrmann 2, 3, 4, 5 in L3/4, Pfirrmann 3, 4 in L4/5 and Pfirrmann 3, 5 in L5/S1(P<0.05). In the smoking group, the disc number proportion of Pfirrmann 4 and 5 in the upper disc levels was higher than in the lower levels, which was statistically significant(P<0.05). Moreover, the average VAS score of the smoking group was higher than that of the non-smoking group(P<0.05). Conclusions: Smoking appears to contribute to the progression of LDD and it can aggravate the severity of low back pain. Furthermore, smoking seems to have more impact to the upper discs than the lower discs.