汉族与蒙古族股骨后髁角及股骨面率的数字化测量对比研究

Comparative study on digital measurement of femoral condylar angle and femoral aspect ratio in Han and Mongolia ethnic groups

目的探讨汉族与蒙古族股骨后髁角及股骨面率在民族之间是否存在解剖形态学差异,为今后行人工全膝关节置换时（total knee arthroplasty,TKA）假体的个体化设计提供数据及理论依据。方法收集符合条件患者60例,其中汉族、蒙古族各30例（各组均男15例,女15例）,年龄23~45岁,平均（36.0±7.2）岁。16排螺旋CT扫描仪（美国GE公司Lightspeed 16）对其进行螺旋扫描,层厚0.625 mm。扫描图像以DICOM格式导出,再利用Mimics 15.0三维重建软件对后髁角及股骨面率进行数字化三维重建测量,以观察其在性别、侧别和民族间是否具有差异性。结果经统计学分析,后髁角及股骨面率在左、右侧别间均无统计学差异;后髁角在蒙古族男、女性别间存在统计学差异（t=2.148,P〈0.05）,在男性组中,蒙、汉族组间存在着统计学差异（t=2.405,P〈0.05）;股骨面率在蒙古族男、女性别间存在统计学差异（t=2.143,P〈0.05）,在男性组中,蒙、汉族组间存在着统计学差异（t=2.191,P〈0.05）,且男性各均值大于女性（除汉族女性外）。结论采用数字化三维重建技术和个体化设计可以针对不同人群选择适当的假体,从而为患者在术后获得良好的治疗效果提供保障。

Objective To explore the difference in the anatomy morphology of the posterior condylar angle（ PCA） and the femoral aspect ratio between Han and Mongolian ethnic groups,and to provide data and theoretical base of the individual prosthesis designing for total knee arthroplasty（ TKA）.Methods Sixty patients were selected,30 patients each in Han and Mongolian groups（ 15 males and 15 females in each group）,aged from 23 to 45,（ 36. 0 ± 7. 2） years in average. The 16 multislice spiral CT（ GE,America） was used for the spiral scanning. The thickness was 0. 625 mm. The scanning images were saved in DICOM formats. The digital three-dimensional（ 3D） reconstruction measurement of the posterior condylar angle and the femoral aspect ratio was performed by Mimics 15. 0 software to analyze the differences in sex,side and nationality. Results Significant differences were found in the posterior condylar angle between the Mongolian male and female（ t = 2. 148,P 0. 05）,and between the Mongolian male and Han male（ t = 2. 405,P 0. 05）; significant differences were also found in the femoral aspect ratio between the Mongolian male and female（ t = 2. 143,P 0. 05）,and between the Mongolian male and Han male（ t = 2. 191,P 0. 05）; the mean value of the Mongolian male was higher than that of Mongolian female. Conclusion Digital 3D reconstruction technology and individualized design can be adopted in choosing suitable prosthesis for different ethnic groups of patients,and thus to ensure the desired treatment effect after the operation.