基于中国一般人群腰痛的杭州腰椎研究的方法学及进展介绍（英文）

Methodology and cohort profile for the Hangzhou Lumbar Spine Study: a study focusing on back health in a Chinese population

目的:开展基于大样本人群的杭州腰椎疾患研究,研究国人一般人群腰痛、腰椎间盘退变、终板病损、Modic改变的流行病学特征以及病理机制。创新点:开展了中国大陆第一个基于大样本的有关腰痛、腰椎间盘退变、终板病损、Modic改变的流行病学研究;开发了一份可信度高的包含腰痛病史以及相关风险因素的调查问卷;采用高分辨率3.0 T核磁共振来分辨腰椎病变特征。方法:从杭州采荷社区中随机抽取人群,完成调查问卷腰痛相关信息记录、腰椎核磁共振扫描、腰椎及股骨颈骨密度测量以及血液样本抽取。从参与人群重复抽取40人进行问卷可信度测量。调查问卷包含的信息包括,人群一般资料、吸烟史、腰痛史、职业史以及运动史,用来记录腰痛发生情况以及相关风险因素。腰椎核磁共振扫描用于观察椎间盘退变、Modic改变以及终板病损等腰椎特征性病变。骨密度测量用来研究与腰椎特征性病变的联系。血液样本用于后续遗传因素的分析。结论:目前已完成301名社区人员调查问卷腰痛相关信息记录、腰椎核磁共振扫描、腰椎及股骨颈骨密度测量以及血液样本抽取;有关腰痛以及相关风险因素的调查问卷可信度高;杭州腰椎疾患研究可对国人腰痛、腰椎间盘退变、终板病损、Modic改变的流行病学特征以及进一步的病理机制研究提供有价值的信息。

Back pain is a worldwide health problem, adding a tremendous burden to modern societies. However, little information on back health is available in China, even though a quarter of the world＇s population is Chinese. To enhance knowledge in this area, we designed and initiated the Hangzhou Lumbar Spine Study, which is a cross-sectional study of a general sample of mainland Chinese with focusing on disc degeneration, Modic changes, endplate lesions, and back pain. The study consists of a structured questionnaire to measure back pain history and lifetime exposure to suspected risk factors, magnetic resonance imaging of the lumbar spine, bone mineral density study of the spine and hip, and DNA sample analysis. Here we briefly introduce the study methodology, report the test-retest reliability of the questionnaire, and describe the cohort profile to date. Since May 2014, 301 randomly selected subjects（male/female, 122/179; mean age, 51.0 years; range, 20–87 years） have been recruited. Tests-retests of the questionnaire, completed by 40 participants, revealed good reliability. To our knowledge, the Hangzhou Lumbar Spine Study is the first population-based epidemiological study conducted to characterize lumbar spinal phenotypes and back pain, their interaction, and their associations with lifetime environmental exposure, in mainland Chinese. Epidemiological information obtained from a reliable questionnaire, magnetic resonance（MR） imaging data, dual energy X-ray absorptiometry（DXA） measurements, and DNA analysis may serve as a valuable reference for future studies on back health, particularly for mainland Chinese.