血清维生素D水平对肩袖撕裂修补术后再撕裂的影响

The correlation between vitamin D level and the retear rate after arthroscopic rotator cuff repair

目的探讨血清维生素D水平对肩袖撕裂修补术后再撕裂的影响。方法回顾性分析2018年1月至2019年6月浙江省东阳市人民医院收治的99例行关节镜下肩袖修补手术的肩袖全层撕裂患者,根据术后再撕裂情况将其分为愈合组83例和再撕裂组16例。比较两组患者年龄、性别、体重指数(BMI)、撕裂部位、受伤因素、病程、撕裂大小、回缩程度、脂肪浸润、维生素D水平等指标。以20μg/L作为临界值,将患者的维生素D水平定义为缺乏和非缺乏。使用二分类Logistic回归分析术后再撕裂的危险因素。结果两组患者年龄、性别、BMI、病程时间、术前疼痛评分、受伤因素等指标比较,其差异均无统计学意义(均P>0.05);两组患者撕裂大小、回缩程度、脂肪浸润程度、维生素D水平等指标比较,其差异均具有统计学意义(均P<0.05)。Logistic回归分析显示,撕裂大小(>3 cm)、脂肪浸润程度(>2级)、维生素D缺乏(<20μg/L)均与肩袖术后再撕裂相关(均P<0.05),OR值分别为17.824(2.953~107.585)、7.190(1.491~35.146)、9.198(1.346~62.850)。结论维生素D缺乏是肩袖修补术后再撕裂的危险因素。

Objective To investigate the correlation between vitamin D level and the retear rate after arthroscopic rotator cuff repair.Methods A retrospective analysis of 99 patients with full-thickness rotator cuff tear underwent arthroscopic rotator cuff repair surgery from January 2018 to June 2019 was carried out in Dongyang People’s Hospital.Patients were divided into healing group and retear group.The basic characteristics,vitamin D level and other indicators were compared between the two groups.With 20μg/L as the cut-off value,patients’vitamin D levels were divided into deficient or non-deficient.Binary logistic regression analysis was used to calculate the correlation between retear rate and different independent variables.P<0.05 was regarded as statistically different.Results There were 83 cases in the healing group and 16 cases in the re-tear group.There was no statistical difference between the two groups in gender,BMI,duration of disease,and injury factors(P>0.05).There was a statistically significant difference in the degree of fat infiltration,vitamin D deficiency,tear size and extent of retraction(P<0.05).The binary logistic regression analysis showed that vitamin D deficiency,the size of the tear and the degree of fat infiltration were related to the re-tear after the rotator cuff repair(P<0.05),and the OR values(95%confidence interval)were 9.198(1.346~62.850),17.824(2.953~107.585),7.190(1.491~35.146)respectively.Conclusions Vitamin D deficiency was the independent risk factor of retear.