慢性乙型肝炎伴骨质疏松性椎体压缩骨折的临床特征

Clinical features of chronic hepatitis B patients with osteopathic vertebral compression fractures

目的:探究慢性乙型肝炎患者骨质疏松性椎体压缩骨折的临床特征.方法:选取2013-01/2015-01贵州省毕节市第三人民医院接受治疗的慢性乙型肝炎患者300例为观察组,并选取同期来贵州省毕节市第三人民医院进行健康检查的100例健康志愿者为对照组,对所有研究对象进行胸腰椎X线片检查,诊断研究对象的脊椎压缩骨折,并测量分析其跟骨骨密度.结果:慢性乙型肝炎肝炎肝病患者的跟骨硬度指数(stiffness index,SI)与对照组的SI值差异具有统计学意义(P<0.05).对照组的SI高于肝硬化A、B、C组患者,且肝硬化A、B、C组患者的S I逐渐降低.观察组中92例骨量减少,58例骨质疏松、30例椎体压缩骨折.对照组中10例骨量减少,6例骨质疏松、3例椎体压缩骨折,比较差异具有统计学意义(P<0.05).肝硬化A、B、C组的椎体压缩骨折发生率逐渐升高.30例慢性乙型肝炎患者中共有53个椎体压缩骨折,其中23个分布在胸腰段、14个胸段和16个腰段,平均每个患者有1.77个椎体发生骨折.对照组中3例椎体压缩骨折有4个椎体骨折,1个位于胸段、1个腰段、2个胸腰段.结论:慢性乙型肝炎患者的硬度指数显著低于对照组,慢性乙型肝炎肝硬化患者发生骨质疏松性椎体压缩骨折的发生率较高,且随着肝硬化严重程度的升高骨质疏松性椎体骨折升高.

AIM：lo explore the clinical teatures ot chronic hepatitis B patients with osteopathic vertebral compression fractures.METHODS：Three hundred patients with chronic hepatitis B treated from January 2013 to January 2015 at the Third People’s Hospital of Bijie City were included in an observation group,and 100 healthy volunteers who underwent a physical examination during the same period were included in a control group.All subjects underwent thoracic and lumbar spine X-ray examination.Diagnostic study of vertebral compression fractures and measurement of bone mineral density were performed.RESULTS：Stiffness index（SI） was significantly lower in the observation group than in the control group.As the severity of cirrhosis increased,SI decreased.In the observation group,reduced bone mass was noted in 92 cases,osteoporosis in 58 cases,and vertebral compression fractures in 30 cases;the corresponding figures in the control group were10,6 and 3,showing significant differences between the two groups（P 〈 0.05）.The incidence of vertebral compression fracture gradually increased as the severity of cirrhosis increased.In 30 chronic hepatitis B patients with vertebral compression fractures,a total of 53 fractures were detected,including 23 located in the thoracolumbar segment,14 thoracic and 16 lumbar,with each patient having an average of1.77 fractures.Three cases in the control group had four vertebral compression fractures,with one located in the thoracicsegment,one lumbar,and two thoracolumbar.CONCLUSION：SI is significantly lower in patients with chronic hepatitis B than in normal people.Chronic hepatitis B patients with cirrhosis have a higher incidence of vertebral compression fractures,and as the severity of cirrhosis increases,the incidence increases.