女性青少年特发性脊柱侧凸患者自我形象评估的相关影响因素分析

The relative factors of self-image in female adolescent idiopathic scoliosis

目的:探讨女性青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者自我形象评估的影响因素。方法:回顾性分析2010年9月～2011年3月在我院就诊的252例女性AIS患者,年龄12～18岁,平均14.5±1.8岁。均摄取患者站立位全脊柱正侧位X线片,并独立填写一份简体中文版SRS-22问卷。在站立位全脊柱正侧位X线片上测量Cobb角、顶椎旋转度、胸椎后凸角、腰椎前凸角、脊柱冠状面力线偏移及脊柱矢状面力线偏移等参数。采用相关分析研究各临床指标与自我形象评分的相关性。结果:患者平均Cobb角35.5°±12.8°;平均顶椎旋转度2.0°±0.7°;平均胸椎后凸角16.2°±9.0°;平均腰椎前凸角51.3°±9.8°;平均脊柱冠状面力线偏移1.2±0.7cm;平均脊柱矢状面力线偏移2.4±1.5cm;平均体重指数18.3±2.2;平均自我形象评分16.7±2.8分。胸弯和胸腰弯/腰弯的自我形象评分均与主弯Cobb角有相关性(r分别为-0.171,-0.225,P均<0.05);其中大角度胸弯组呈显著相关(r=-0.484,P=0.005)。而其他参数与患者自我形象评估均无明显相关性(P均>0.05)。结论:女性AIS患者的自我形象主要受主弯Cobb角的影响,其中大角度胸弯患者的自我形象受主弯Cobb角的影响最大。

Objectives： To assess the influencing factors of self-image in adolescent idiopathic scoliosis girls.Methods： Retrospective analysis of 252 AIS girls,selected from September 2010 to March 2011,with mean age of 14.5±1.8 years（range from 12 to 18 years）.All patients took the standing posteroanterior and lateral radiographs of spine and the completed simplified Chinese version of SRS-22 questionnaire.The Cobb angle apical vertebral rotation,thoracic kyphosis,lumber lordosis,C7PL,and SVA were evaluated.The relationships between these clinical index and self-image results were assessed using correlation analysis.Results： The patients was included in this sudy with mean Cobb angle 35.5° ± 12.8°;mean apical rotation 2.0±0.7°;mean thoracic kyphosis 16.2±9.0°;mean lumber Lordosis 51.3±9.8°;mean C7-CSL 1.2±0.7cm;mean SVA 2.4±1.5cm;mean BMI 18.3±2.2;mean self-image 16.7 ± 2.8.Correlation analysis showed the major Cobb angle as the significant predictor of self-image in thoracic curve and lumbar curve groups.For the subgroup of thoracic AIS patients with Cobb angle 〉45°,the correlation was more significant（r=-0.484,P=0.005）.There was no significant correlation between other factors and self-image results.Conclusions： The self-image in female AIS,especially in thoracic female AIS,is influenced by the large Cobb angle.