青少年特发性脊柱侧凸严重程度和弯型与SRS-22问卷评分的相关性分析

Correlation of curve patterns and severity with SRS-22 questionnaire scores in girl adolescents with idiopathic scoliosis

目的：探讨青少年特发性脊柱侧凸（adolescent idiopathic scoliosis，AIS）不同弯型及不同Cobb角与SRS-22问卷各维度评分的相关性。方法：对2010年6月~2011年7月在我科就诊且填写SRS-22简体中文版问卷的272例未经任何治疗的女性AIS患者进行回顾性分析。根据冠状面Cobb角将所有患者分为小Cobb角（20°~39°）和大Cobb角（40°~75°）两组，并根据弯型特征将每组患者分为单胸弯、单胸腰弯/腰弯、双胸弯、胸腰双弯四个亚组。对同一Cobb角组内不同弯型亚组间和不同Cobb角组间同一弯型患者的SRS-22问卷各维度评分差异均采用Kruskal-Wallis检验。结果：小Cobb角组单胸弯和单胸腰弯/腰弯患者的功能活动、自我形象、精神健康评分明显高于大Cobb角组的患者（P〈0.05），双胸弯患者的功能活动评分和总分均显著优于大Cobb角组的患者（P〈0.05）。在小Cobb角组中，单胸弯患者的功能活动评分显著高于单胸腰弯/腰弯和胸腰双弯患者（P〈0.05）；自我形象评分双胸弯患者明显低于单胸弯患者和单胸腰弯/腰弯患者（P〈0.05）。在大Cobb角组中，胸腰双弯患者的疼痛评分明显低于单胸弯患者（P〈0.05）；自我形象评分双胸弯患者明显低于其他三种弯型患者（P〈0.05）。结论：在轻中度女性AIS中，Cobb角大小及弯型特征对患者的SRS-22问卷评分会造成一定程度的影响, 其中双胸弯对患者的自我形象评分的影响尤为明显。

Objectives： To investigate the correlation of SRS-22 questionnaire scores with curve patterns and curve severity in girls with adolescent idiopathic scoliosis（AIS）. Methods： From June 2010 to July 2011, 272 female AIS patients without any treatment who completed a simplified Chinese edition of SRS-22 questionnaire were recruited in present study. All girls were divided into two groups： small Cobb angle（20°-39°） group and large Cobb angle（40°-75°） group. In addition, according to the curve patterns, each group was furtherly divided into four subgroups： main thoracic curve（T）, thoracolumbar curve/lumbar（TL/L）, double major curve（DM） and double thoracic curve（DT）. Statistical analysis was performed among different subgroups in the same group and between the same subgroups in different groups by using nonparametric test with Kruskal-Wallis. Results： In the small Cobb angle group, the function/activity domain scores, self-image domain scores, and mental health domain scores of patients with T curve and TL/L curve were significantly higher than those in the large Cobb angle group（P〈0.05）, and the function/activity domain scores and total sub-scores of DT curve patients were significantly better than those in the large Cobb angle group（P〈0.05）. Furthermore, the function/activity domain scores of T curve patients were notably higher compared with those of TL/L and DM curve patients（P〈0.05）. However, the self-image domain scores of DT curve patients were significantly worse than those of T and TL/L curve patients（P〈0.05）. In the large Cobb angle group, the pain domain scores of DM curve patients were significantly lower compared with those of T curve patients（P〈0.05）, and the self-image domain scores of DT curve patients were the lowest among all the curve patterns（P〈0.05）. Conclusions： In the girl patients with mild to moderate AIS, the different curve severity and curve patterns, to a certain extent, may have an effect on the SRS-22 questionnaire scores; especially the AIS patients with DT curve have significantly lower self-image scores.