主动脉机械应力对强直性脊柱炎患者胸椎椎体骨赘的影响研究

The effect of aortic mechanical stress on osteophyte of thoracic vertebral bodies in AS patients

目的:探讨主动脉应力对强直性脊柱炎(AS)患者胸椎椎体骨赘形成的影响。方法:选取医院收治的116名强直性脊柱炎患者,均行CT扫描后将医学数字成像及通信(DICOM)图像文件导入适形计划系统行三维重建,测量骨赘高度、骨赘体积及主动脉到椎体边缘的最小距离(MinAV),分析骨赘Min AV与骨赘体积、高度及形成的相关性。结果:T11椎体Min AV与骨赘体积和高度呈负相关(r=-0.618,r=-0.737;P<0.05),其余胸椎Min AV与骨赘体积和高度无相关性。有骨赘椎体Min AV大于无骨赘,T7~10椎体Min AV的有骨赘与无骨赘比较,差异有统计学意义(t=2.103,t=3.314,t=9.548,t=2.298,P<0.05),T11~T12椎体Min AV与骨赘形成无关。结论:主动脉与胸椎椎体的距离与骨赘发生具有相关性,可能与主动脉机械应力有关,但机械应力大小目前尚无直接检测方法,骨赘的形成也存在着复杂的机制,需进一步研究予以证实。

Objective: To explore the effect of aortic mechanical stress on osteophyte of thoracic vertebral bodies in patients with ankylosing spondylitis(AS). Methods: A total of 116 AS patients who admitted to hospital were selected.The digital imaging and communications in medicine(DICOM) image files were introduced into conformal plan system to conduct three dimensional(3D) reconstruction after they underwent computed tomography(CT) scan. The height and volume of osteophyte, and the minimum distance between the aorta and the marge of vertebral bodies(MinAV) were measured, and the correlations between MinAV and volume of osteophyte, and between MinAV and height of osteophyte,and between MinAV and formation of osteophyte were further analyzed. Results: MinAV of T11 vertebral body was negatively correlation with the volume and height of osteophyte(r=-0.618, r=-0.737, P<0.05), respectively. And other thoracic MinAVs were not correlation with the volume and height of osteophyte. The thoracic MinAV with osteophyte was larger than that without osteophyte, and the difference between MinAV of T7-10 vertebral bodies with osteophyte and those without osteophyte were significant(t=2.103, t=3.314, t=9.548, t=2.298, P<0.05), respectively. There were no correlations between MinAV of T11-T12 vertebral bodies and osteophyte formation. Conclusion: The distance between aorta and thoracic vertebra body is correlation with the occurrence of osteophytes, which may be related to the aortic mechanical stress. However, there is no direct detection method for mechanical stress, and there is a complex mechanism in the formation of osteophytes. Therefore, the above results should be confirmed by further studies.