中国南方汉族妇女正常骨盆形态变化特点及其与年龄的相关性

Analysis of normal pelvis morphometry of modern Chinese southern Han female and its correlation with age

目的 探讨中国南方汉族妇女正常骨盆形态变化特点及其与年龄的相关性.方法 2009年8月至2011年9月南方医科大学南方医院因各种指征行盆腔CT检查的289例汉族妇女,平均年龄43.5岁,四肢发育正常,排除病理性骨盆.根据年龄分为25～ 40岁组（109例）；41～ 50岁组（115例）；50岁以上组（65例）.采用双源CT检测仪对3组妇女盆腔进行扫描,应用Mimics软件构建出骨盆的数字化三维模型,测量三维模型骨盆的入口后矢状径、入口前后径、骶耻内径；中骨盆后矢状径、中骨盆前后径；出口横径、出口后矢状径及耻骨联合高度,并对测量的各径线值或角度值与妇女平均年龄进行相关性分析.结果 （1）25～40岁组、41 ～ 50岁组、50岁以上组妇女骨盆入口后矢状径分别为（53±8）、（51±7）、（48 ±6） mm,入口前后径分别为（122±8）、（120±9）、（114±8） mm,骶耻内径分别为（135±10）、（132±9）、（127 ±9） mm,3组分别比较,差异有统计学意义（P＜0.01）；（2）中骨盆后矢状径分别为（43±6）、（44±6）、（43 ±7） mm,中骨盆前后径分别为（119±8）、（120±8）、（119±7）mm,3组分别比较,差异无统计学意义（P＞0.05）；（3）出口横径分别为（122±11）、（121±10）、（117±11） mm,出口后矢状径分别为（56±9）、（58±8）、（57 ±9） mm,3组分别比较,差异无统计学意义（P＞0.05）；（4）耻骨联合高度分别为（31±3）、（33±3）、（34±3）mm,3组分别比较,差异有统计学意义（P＜0.01）；（5）耻骨联合高度与年龄存在正相关关系（r=0.331,P＜0.01）,骨盆入口后矢状径、入口前后径、骶耻内径、出口横径、骶骨长度和弯度等与年龄存在负相关关系（r=-0.120～-0.343,P＜0.05）.结论 中国南方汉族妇女的骨盆入口随年龄增长由长椭圆形趋于横椭圆形,骨盆变深,骶骨变弯；但中骨盆平面、骨盆出口平面的变化不明显,且显示出与年龄增长无关的特点.

Objective To analyze the normal pelvis morphometry of Chinese southern Han female and its correlation with age.Methods From.August 2009 to September 2011,289 Han nationality females who received pelvis CT scan at Nanfang Hospital of Southern Medical University were eligible for the study.Their mean age was 43.5 years,with normal body development and no pelvic abnormality.The patients were divided into 3 age groups：25 to 40 （n =109）,41 to 50 （n =115）,and 〉 50 years （n =65）.After constructing a three-dimensional digital model of the pelvis,the following parameters were measured,including transverse inlet diameter,posterior sagittal diameter of pelvic inlet,sagittal inlet,diagonal conjugate,biischial diameter,posterior sagittal diameter of midpelvis,sagittal midpelvic diameter,intertuberous distance,posterior sagittal diameter of outlet,angle of pubic arch,sagittal outlet,penal height,sacrum length and sacrum curvature.The relationship between all parameters and age was analyzed.Results （1） The posterior sagittal diameters of pelvic inlet of the 25 to 40 age group,41 to 50 age group,〉50 years age group were （53 ±8）,（51 ±7）,（48 ±6） mm.The sagittal inlet of the three groups were （122 ±8）,（120 ±9）,（114 ±8） mm.And the diagonal conjugate of the three groups were （135 ± 10）,（132 ± 9）,（127 ± 9） mm.All had significant differences among the three groups （P 〈 0.01）.（2） The posterior sagittal diameter of midpelvis of the three groups were （43 ± 6）,（44 ± 6）,（43 ±7） mm,and the sagittal midpelvic diameter of the three groups were （119 ± 8）,（120 ± 8）,（119 ±7） mm,with no significant difference among the three groups （P 〉 0.05）.（3） The intertuberous distance of the three groups were （122 ± 11）,（121 ± 10）,（117 ± 11） mm,and the posterior sagittal diameter of outlet of the three groups were （56 ± 9）,（58 ± 8）,（57 ± 9） mm.There was no significant difference among the three groups（P 〉0.05）.（4） Penal height of three groups were （31 ±3）,（33 ±3）,（34 ± 3） mm,there was with significant differences （P 〈 0.01）.（5） Pearson correlation analysis showed that penal height was positively correlated with age （r =0.331,P 〈 0.05）,while sagittal inlet,posterior sagittal diameter of inlet,diagonal conjugate,intertuberous distance,angle of pubic arch,sacrum length and sacrum curvature were negatively correlated with age （r =-0.120 to-0.343,P 〈 0.05）.Conclusions The shape of the pelvic inlet of Chinese southern Han female changed from sagittal elliptic into transverse elliptic form,and the posterior part of pelvic inlet became larger.Sacral concavity was increased and the pelvis became deeper.Mid pelvis and the pelvic outlet was almost unchanged,and showed no correlation with age.