前交叉韧带断裂发生部位及其影响因素的多元Logistic回归分析

Occurring sites of anterior cruciate ligament rupture and multivariate Logistic regression analysis for its influencing factors

目的 探讨前交叉韧带(ACL)实质部完全断裂各个部位的发生率及影响因素。方法选择2004年10月~2015年8月在唐山市人民医院治疗的78例ACL损伤并经关节镜探查确认韧带实质部完全断裂患者的临床资料,分析上、中、下三部分的发生率,采用多因素Logistic回归分析年龄、性别、损伤侧别、损伤机制和损伤时膝关节位置对断裂部位的影响。结果上、中、下三段断裂的发生率分别为78.21%(61/78)、20.51%(16/78)、1.28%(1/78)(P<0.05);不同年龄、不同损伤机制的患者发生ACL上段断裂的概率不同(P<0.05);性别、损伤侧、损伤时关节位置与ACL断裂部位不相关(P>0.05);与≥30岁相比,<30岁更容易发生ACL上段断裂,发生危险上升4.855倍(OR=4.855,95%CI:2.659~9.004,P=0.000);与非接触性相比,接触性发生ACL上段断裂的危险上升10.549倍(OR=10.549,95%CI:5.156~15.266,P=0.000)。结论 ACL实质部完全断裂近3/4发生在上段,1/4左右发生在中段,下段极少发生;断裂部位与年龄、损伤机制有一定关联。

Objective To investigate the occurring sites of anterior cruciate ligament rupture and explore its influencing factors. Methods From October 2004 to August 2015, in People’s Hospital of Tangshan City, the clinical data of 78 patients with injury and confirmed by arthroscopic probe substance section ligament complete rupture were selected.The incidence of the occurring upper, middle, lower site of ACL was analyzed. The influence of age, sex, knee injury mechanisms and injury joint position on the fracture site was analyzed by multivariate Logistic regression analysis. Results Three sections of the fracture incidence were 78.21%(61/78), 20.51%(16/78), 1.28%(1/78)(P < 0.05); the probability of patients with different age and different injury mechanism occured ACL upper site probability was different(P <0.05); gender, lesion side, damage joints were not related to site of ACL(P > 0.05); compared with ≥30 years, those who were <30 years were more prone to ACL on segment fracture, the risk of increased 4.855 times(OR = 4.855, 95%CI:2.659-9.004, P = 0.000); compared with the non-contact, the risk of rupture of the segment ACL contact occurs rose10.549 times(OR = 10.549, 95%CI: 5.156-15.266, P = 0.000). Conclusion Nearly three-quarters of ACL occurs on the first segment, about 1/4 occurs in the middle segment and lower segments rarely occurs; cleavage site may influenced by age, injury mechanisms.