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[1]葉子揚,葉秀云,胡艇.前交叉韌帶斷裂合并半月板撕裂的解剖學影響因素分析[J].中醫(yī)正骨,2023,35(10):21-25.
　YE Ziyang,YE Xiuyun,HU Ting.Analysis of anatomic factors influencing anterior cruciate ligament rupture combined with meniscus tears[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(10):21-25.
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前交叉韌帶斷裂合并半月板撕裂的解剖學影響因素分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第35卷
期數(shù):
2023年10期
頁碼:
21-25
欄目:
臨床研究
出版日期:
2023-10-20

文章信息/Info

Title:
Analysis of anatomic factors influencing anterior cruciate ligament rupture combined with meniscus tears
作者:
葉子揚; 葉秀云; 胡艇
溫州市中心醫(yī)院,浙江 溫州 325000
Author(s):
YE Ziyang; YE Xiuyun; HU Ting
Wenzhou Central Hospital,Wenzhou 325000,Zhejiang,China
關鍵詞:
膝損傷;  前交叉韌帶損傷;  半月板;  解剖學;  Logistic模型;  ROC曲線
Keywords:
knee injuries;  anterior cruciate ligament injuries;  meniscus;  anatomy;  Logistic models;  ROC curve
摘要:
目的:分析前交叉韌帶(anterior cruciate ligament,ACL)斷裂合并半月板撕裂的解剖學影響因素。方法:納入ACL斷裂患者141例,從病歷系統(tǒng)中提取患者的性別、年齡、損傷側(cè)別、體質(zhì)量指數(shù)、是否合并半月板撕裂等信息。在影像歸檔和通信系統(tǒng)中提取患者MRI,測量股骨髁間窩寬度指數(shù)、α角、β角、脛骨外側(cè)平臺后傾角和脛骨內(nèi)側(cè)平臺后傾角等解剖學參數(shù)。根據(jù)半月板是否撕裂將納入的患者分為合并半月板撕裂組和不合并半月板撕裂組。先對2組患者的相關信息進行單因素對比分析,然后對其中組間差異有統(tǒng)計學意義的因素進行多因素Logistic回歸分析。采用受試者操作特征(receiver operating characteristic,ROC)曲線分析評價解剖學影響因素診斷ACL斷裂合并半月板撕裂的價值。結(jié)果:合并半月板撕裂組76例,不合并半月板撕裂組65例。2組患者性別、股骨髁間窩寬度指數(shù)、α角、β角、脛骨內(nèi)側(cè)平臺后傾角、脛骨外側(cè)平臺后傾角的比較,組間差異均有統(tǒng)計學意義(χ2=5.248,P=0.022; 0.247±0.032,0.273±0.024,t=5.501,P=0.000; 46.70°±7.04°,50.73°±7.76°,t=3.207,P=0.000; 41.48°±2.22°,38.30°±3.16°,t=6.805,P=0.000; 6.85°±2.59°,5.61°±1.76°,t=3.363,P=0.000; 8.04°±3.32°,5.34°±1.83°,t=6.690,P=0.000)。Logistic回歸分析結(jié)果顯示,股骨髁間窩寬度指數(shù)、β角、脛骨外側(cè)平臺后傾角是ACL斷裂合并半月板撕裂的影響因素(β=-1.118,P=0.000,OR=3.060; β=0.530,P=0.000,OR=3.985; β=1.372,P=0.000,OR=3.944)。ROC曲線分析結(jié)果顯示,股骨髁間窩寬度指數(shù)、β角、脛骨外側(cè)平臺后傾角診斷ACL斷裂合并半月板撕裂的臨界值分別為0.250、38°、8°,敏感度分別為83.2%、88.8%、56.6%,特異度分別為60.8%、56.8%、88.6%,ROC曲線下面積分別為0.683(P=0.001)、0.647(P=0.006)、0.651(P=0.005)。結(jié)論:股骨髁間窩寬度指數(shù)、β角、脛骨外側(cè)平臺后傾角是ACL斷裂合并半月板撕裂的解剖學影響因素,應用股骨髁間窩寬度指數(shù)、β角、脛骨外側(cè)平臺后傾角診斷ACL斷裂合并半月板撕裂具有一定的價值。
Abstract:
Objective:To analyze the anatomic factors influencing anterior cruciate ligament(ACL)rupture combined with meniscus tears(MTs).Methods:One hundred and forty-one patients with ACL rupture were enrolled in the study.The information about gender,age,injuried side,body mass index,whether combined with MTs was extracted from the electronic medical record system(EMRS).Moreover,the magnetic resonance imaging(MRI)of the included patients were extracted from the picture archiving and communication system(PACS),and the anatomical parameters including femoral intercondylar fossa(ICF)width index,angle α,angle β,lateral posterior tibial slope(PTS)and medial PTS were measured on the MRI images.The included patients were divided into MTs group and non-MTs group according to whether the MTs were present.The single-factor comparative analysis was performed on the relevant information of patients in the 2 groups,followed by multi-factor logistic regression analysis on the factors with statistically significant differences between the 2 groups.Furthermore,the values of anatomic factors in diagnosing ACL rupture combined with MTs were analyzed and evaluated by using receiver operating characteristic(ROC)curve.Results:One hundred and forty-one patients with ACL rupture were included in the final analysis,76 cases in MTs group and 65 cases in non-MTs group.The information including gender,femoral ICF width index,angle α,angle β,medial PTS and lateral PTS was compared between the 2 groups,and the results revealed that the differences were statistically significant(χ2=5.248,P=0.022; 0.247±0.032 vs 0.273±0.024,t=5.501,P=0.000; 46.70±7.04 vs 50.73±7.76 degrees,t=3.207,P=0.000; 41.48±2.22 vs 38.30±3.16 degrees,t=6.805,P=0.000; 6.85±2.59 vs 5.61±1.76 degrees,t=3.363,P=0.000; 8.04±3.32 vs 5.34±1.83 degrees,t=6.690,P=0.000).The results of logistic regression analysis showed that the femoral ICF width index,angle β and lateral PTS were the anatomic factors influencing ACL rupture combined with MTs(β=-1.118,P=0.000,OR=3.060; β=0.530,P=0.000,OR=3.985; β=1.372,P=0.000,OR=3.944).The results of ROC curve analysis showed that the diagnostic cut-off values of femoral ICF width index,angle β and lateral PTS in diagnosing ACL rupture combined with MTs were 0.250,38 degree and 8 degree; the sensitivity were 83.2%,88.8% and 56.6%; the specificities were 60.8%,56.8% and 88.6%; the areas under ROC curve were 0.683(P=0.001),0.647(P=0.006)and 0.651(P=0.005)respectively.Conclusion:The femoral ICF width index,angle β and lateral PTS are the anatomic factors influencing ACL rupture combined with MTs,and they have a certain application values in diagnosis of ACL rupture combined with MTs.

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備注/Memo

備注/Memo:
通訊作者:胡艇 E-mail:[email protected]
更新日期/Last Update: 1900-01-01