腰椎间盘退变危险因素的病例-对照研究

Case-control Study for Risk Factors of Lumbar Disc Degeneration

[目的]探索腰椎间盘退变的危险因素。[方法]采用病例-对照研究方法,以CT确诊有腰椎间盘退变者114人为病例组;随机选择体检人员中无腰背痛史且腰椎功能正常者211人为对照。问卷调查腰椎疾患家族史、腰背部受伤史和5种职业危险因素的暴露情况,包括坐位、全身振动、弯腰扭腰、提举重物和重体力作业,对各因素暴露以工龄权重求得暴露指数。[结果]非条件Logistic回归分析显示腰椎疾患家族史危险性最高(OR=89.12),其次是腰背部受伤史(OR=78.60)、职业危险因素中全身振动(OR=8.58)、弯腰扭腰(OR=4.62)和重体力作业(OR=9.05)进入模型。业余运动OR为0.47。[结论]腰椎疾患家族史和腰背部受伤史是腰椎间盘退变的主要危险因素,而业余运动可能有一定保护作用。

[ Objective ] To explore risk factors of lumbar disc degeneration. [ Methods ] 114 cases were diagnosed as lumbar disc degeneration by CT and 211 controls without low back pain history were randomly invited from community population. 5 occupational risk factors including sitting, whole body vibration, bending/twisting, lifting and heavy work were investigated to calculate exposure index by weighing employment years, family history of lumbar disc diseases and back injury history were also concerned. [ Results ] Analyzed by non-conditional logistic method, the risk of family history of lumbar disc diseases was the highest （ OR=89.12 ） followed by back injury history （ OR=78.60 ）. Among 5 occupational factors, whole body vibration（ OR=8.58 ）, bending/twisting （ OR=4.62 ）, heavy work （ OR=9.05 ） were significantly related with lumbar disc degeneration. OR of physical exercises was 0.47. [ Conclusion ] Family history of lumbar disc diseases and back injury history are main risk factors for lumbar disc degeneration, and physical exercises might be a protective factor.