脑瘫患者髋关节骨质减少特征：一项基于医院的研究。

Osteopenic features of the hip joint in patients with cerebral palsy: a hospital-based study.

作者信息

Moon Sang Young, Kwon Soon-Sun, Cho Byung Chae, Chung Chin Youb, Lee Kyoung Min, Sung Ki Hyuk, Chung Myoung Ki, Zulkarnain Arif, Kim Yong Sung, Park Moon Seok

机构信息

Department of Orthopaedic Surgery, Yeol Lin Hospital, Kyungki, South Korea.

Department of Mathematics, Ajou University, Kyungki, South Korea.

出版信息

Dev Med Child Neurol. 2016 Nov;58(11):1153-1158. doi: 10.1111/dmcn.13146. Epub 2016 May 4.

DOI:10.1111/dmcn.13146

PMID:27145375

Abstract

AIM

We aimed to evaluate the bone mineral density of the hip joint in patients with cerebral palsy (CP).

METHOD

Patients with CP younger than 18 years who underwent three-dimensional hip examination by computed tomography were analysed. Bone attenuation of the acetabulum and femur was measured as Hounsfield units (HU), and was adjusted for affecting factors such as hip instability and Gross Motor Function Classification System (GMFCS).

RESULTS

One hundred and twenty-six patients with CP and 86 typically developing participants were included. The average bone attenuation was significantly lower in those with CP than in the comparison group (acetabulum: 70.8HU, 95% confidence interval [95% CI] 59.9-81.8; femur: 82.2HU, 95% CI 70.4-95.8). Compared with GMFCS levels I to III, bone attenuation was significantly lower for GMFCS levels IV (acetabulum: 30.9HU, 95% CI 15.7-46.2; femur: 39.7HU, 95% CI 19.9-59.5) and V (acetabulum: 51.7HU, 95% CI 35.9-67.5; femur: 72.5HU, 95% CI 51.9-93.0). The average bone attenuation decreased when the migration percentage was over 37% (acetabulum: 11.6HU, 95% CI 1.4-24.6; femur: 26.8HU, 95% CI 9.9-43.6).

INTERPRETATION

Bone attenuation of the acetabulum and femur was significantly affected both by GMFCS level and by severity of hip instability.

摘要

目的

我们旨在评估脑瘫（CP）患者髋关节的骨密度。

方法

对18岁以下接受计算机断层扫描三维髋关节检查的CP患者进行分析。髋臼和股骨的骨衰减以亨氏单位（HU）测量，并针对髋关节不稳定和粗大运动功能分类系统（GMFCS）等影响因素进行调整。

结果

纳入了126例CP患者和86名发育正常的参与者。CP患者的平均骨衰减明显低于对照组（髋臼：70.8HU，95%置信区间[95%CI]59.9 - 81.8；股骨：82.2HU，95%CI 70.4 - 95.8）。与GMFCS I至III级相比，GMFCS IV级（髋臼：30.9HU，95%CI 15.7 - 46.2；股骨：39.7HU，95%CI 19.9 - 59.5）和V级（髋臼：51.7HU，95%CI 35.9 - 67.5；股骨：72.5HU，95%CI 51.9 - 93.0）的骨衰减明显更低。当移位百分比超过37%时，平均骨衰减降低（髋臼：11.6HU，95%CI 1.4 - 24.6；股骨：26.8HU，95%CI 9.9 - 43.6）。