脊柱骨质疏松性椎体压缩骨折椎体成形术后患者卧床时间与再骨折的关系

The relationship between the bed rest time and the re-fracture after percutaneous vertebroplasty for spinal osteoporotic vertebral compression fracture

目的探讨脊柱骨质疏松性椎体压缩骨折(OVCF)椎体成形术后患者卧床时间与再骨折的关系。方法将200例OVCF椎体成形术后患者(OVCF组)依据术后1年是否再骨折分为再骨折组(n=50)和无再骨折组(n=150)。记录两组卧床时间。同期选取非OVCF志愿者50例(非OVCF组)作为对照。检测所有研究对象骨转换指标[Ⅰ型胶原羧基端肽β特殊序列(β-CTX)、Ⅰ型前胶原N端前肽(P1NP)]、椎体骨密度(BMD),分析卧床时间与再骨折的关系。结果OVCF组β-CTX明显高于非OVCF组,OVCF组P1NP、椎体BMD明显低于非OVCF组,差异均有统计学意义(P<0.001)。再骨折组术后卧床时间、β-CTX明显高于无再骨折组,P1NP、椎体BMD明显低于无再骨折组,差异均有统计学意义(P<0.001)。Pearson相关性分析结果显示,卧床时间与β-CTX呈正相关(P<0.001),与P1NP、椎体BMD呈负相关(P<0.001)。结论OVCF椎体成形术后患者卧床时间与再骨折的发生有关,卧床时间长可能会引起骨转换紊乱而导致BMD下降,从而引起再骨折的发生。

Objective To investigate the relationship between the bed rest time and the re-fracture after percutaneous vertebroplasty for spinal osteoporotic vertebral compression fracture(OVCF).Methods The 200 patients after vertebroplasty with OVCF(OVCF group)were divided into re-fracture group(n=50)and non-fracture group(n=150)according to whether they had re-fracture at 1 year after operation,the bed time was recorded in two groups.At the same time,50 non-OVCF volunteers(non-OVCF group)were selected as controls.The bone conversion index[typeⅠcollagen carboxyl end peptide beta special sequence(beta-CTX),typeⅠprocollagen N endpeptide(P1NP)],vertebral bone mineral density(BMD)were detected in all subjects,the relationship between bed time and re-fracture were analyzed.Results Theβ-CTX in OVCF group was significantly higher than that in non-OVCF group,P1NP and vertebral BMD in OVCF group were significantly lower than those in non-OVCF group,the differences were statistically significant(P<0.001).The bed rest time andβ-CTX of re-fracture group were significantly higher than those in the non-fracture group,the P1NP and vertebral BMD in the re-fracture group were significantly lower than those in the non-fracture group,the differences were statistically significant(P<0.001).Pearson correlation analysis showed that the bed time was positively correlated withβ-CTX(P<0.001),and it was negatively correlated with P1NP and vertebral BMD(P<0.001).Conclusions The bed time of patients with OVCF after percutaneous vertebroplasty is related to the occurrence of re-fracture,the long time in the bed may cause the disorder of bone transformation,and lead to the decrease of BMD,which causes the occurrence of re-fracture.