不同病因早期非创伤性股骨头坏死初始发病部位差异分析

Differences of initial onset sites of non-traumatic osteonecrosis of the femoral head with different etiologies at early stage

目的探讨不同病因非创伤性股骨头坏死(ONFH)初始发病部位的差异。方法收集郑州大学第一附属医院骨科诊治的早期非创伤性ONFH 184例309髋,其中酒精性ONFH 93例153髋,激素性ONFH 65例110髋,特发性ONFH 26例46髋。根据中日友好医院ONFH分型方法以坏死部位分为5组。应用SPSS 17.0统计软件对各组数据进行统计学分析。结果不同病因分组初始发病部位差异有统计学意义(P<0.05)。酒精性ONFH组与激素性ONFH组初始发病部位差异有统计学意义(P<0.001)。酒精性ONFH组与特发性ONFH组之间差异无统计学意义(P>0.05);激素性ONFH组与特发性ONFH组之间差异无统计学意义(P>0.05)。不同病因分组中坏死灶均无内侧组者。酒精性ONFH的初始发病部位多在极外侧组(20.92%),激素性ONFH初始发病部位多在中央组(13.64%),差异有统计学意义(P<0.001)。结论激素性ONFH初始发病部位多在股骨头偏内侧,酒精性ONFH多在股骨头偏外侧。

Objective To explore the differences of initial onset sites of non-traumatic osteonecrosis of the femoral head(ONFH)with different etiologies.Methods A total of 184 patients(309 hips)suffered from the non-traumatic ONFH in early stage treated in the First Affiliated Hospital of Zhengzhou University were sellected.There were 93 cases(153 hips)of alcohol-induced ONFH,65 cases(110 hips)of steroid-induced ONFH,and 26 cases(46 hips)of idiopathic ONFH among them.The femoral heads were divided into 5 groups according to the China-Japan Friendship Hospital classification of ONFH.The data were analyzed by SPSS 17.0.Results There were statistically significant differences in the initial onset sites among these groups with different etiologies(P<0.05).There was a statistical difference in the initial onset sites between alcohol group and steroid group(P<0.001).There was no statistical difference between alcohol group and idiopathic group(P>0.05),and there was no statistical difference between steroid group and idiopathic group(P>0.05).The medial-type osteonecrosis was not found in these groups with different etiologies.The inistial onset site of alcohol-induced ONFH was mostly in the complete lateral type group(20.92%),and the initial onset site of steroid-induced ONFH was mostly in the central type group(13.64%),and the difference was statistically significant(P<0.001).Conclusion The initial onset site of steroid-induced ONFH mostly occurred on the medial side of the femoral head,and the alcohol-induced ONFH mostly occurred on the lateral side of the femoral head.