[1]鲁齐林 竺义亮△ 李绪贵 王小阵 陈龙 熊承杰 蔡贤华.2型糖尿病对狭窄腰椎管内结构参数的影响[J].中国中医骨伤科杂志,2020,28(01):38-42.
　LU Qilin ZHU Yiliang LI Xugui WANG Xiaozhen CHEN Long XIONG Chengjie CAI Xianhua.The Effect of Type 2 Diabetes Mellitus on the Parameters of Stenotic Lumbar Spinal Canal[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2020,28(01):38-42.
点击复制

2型糖尿病对狭窄腰椎管内结构参数的影响()
分享到：

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第28卷
期数:
2020年01期
页码:
38-42
栏目:
临床研究
出版日期:
2020-01-15

文章信息/Info

Title:
The Effect of Type 2 Diabetes Mellitus on the Parameters of Stenotic Lumbar Spinal Canal
文章编号:
1005-0205(2020)01-0038-05
作者:
鲁齐林1 竺义亮1△ 李绪贵1; 2 王小阵2 陈龙2 熊承杰3 蔡贤华1; 3
1湖北中医药大学(武汉,430065) 2湖北六七二中西医结合骨科医院骨科 3中国人民解放军中部战区总医院骨科
Author(s):
LU Qilin1 ZHU Yiliang1△ LI Xugui1; 2 WANG Xiaozhen2 CHEN Long2 XIONG Chengjie3 CAI Xianhua1; 3
1Hubei University of Chinese Medicine,Wuhan 430065,China; 2Department of Orthopaedics,Hubei 672 Orthopaedics Hospital of Integrated Chinese & Western Medicine,Wuhan 430079,China; 3Department of Orthopaedics,The General Hospital of Central Theater Command,Wuhan 430070,China.
关键词:
2型糖尿病;  腰椎管狭窄症;  黄韧带肥厚;  巨噬细胞移动抑制因子
Keywords:
type 2 diabetes mellitus;  lumbar spinal canal stenosis;  hypertrophic lumbar ligamentum flavum;  macrophage migration inhibitory factor
分类号:
R681.5
文献标志码:
A
摘要:
目的:探究合并2型糖尿病与否对腰椎管狭窄症患者中椎管内相应参数是否产生影响。方法:回顾性分析解放军中部战区总医院3年(2016年1月1日至2019年1月1日)来所有腰椎管狭窄住院患者。在隐藏病史情况下行单盲测量,对比合并2型糖尿病组(DM+)与非合并2型糖尿病组(DM-)在黄韧带厚度、下关节突间距及椎管有效腔隙矢状径方面是否存在差异。结果:通过测量与对比研究发现,合并2型糖尿病组与非合并2型糖尿病组黄韧带厚度分别为(5.23±0.71)mm和(4.42±0.60)mm,下关节突间距为(11.32±1.23)mm和(12.09±1.57)mm,椎管有效腔隙矢状径为(7.57±1.87)mm和(8.24±1.74)mm; 两组在此三种参数中差异有统计学意义(P<0.05)。结论:2型糖尿病对腰椎管狭窄症患者椎管内相应参数产生一定影响,其可能对腰椎管狭窄的发生有诱发作用。
Abstract:
Objective:To explore the effect of type 2 diabetes mellitus on the parameters of lumbar spinal canal among lumbar spinal stenosis patients.Methods:All patients with lumbar spinal stenosis from the The General Hospital of Central Theater Command in the past three years were retrospectively analyzed.Single-blind measurements were performed to compare the thickness of ligamentum flavum,the distances between inferior articular processes and the sagittal diameter of the effective lumen between the patients with(DM+)and without type 2 diabetes mellitus(DM-).The differences between the two groups were studied.Results:The thickness of ligamentum flavum in DM+ group and DM- group were(5.23±0.71)mm vs(4.42±0.60)mm(P<0.05).The distances between inferior articular processes in DM+ group and DM- group were(11.32±1.23)mm vs(12.09±1.57)mm.The sagittal diameter of the effective lumen of the vertebral canal in DM+ group and DM- group were(7.57±1.87)mm vs(8.24±1.74)mm.There were statistical differences in these three parameters between those two groups(P<0.05).Conclusion:Type 2 diabetes mellitus affects the parameters of the lumbar spinal canal among patients with lumbar spinal stenosis and it may contribute to lumbar spinal stenosis.

参考文献/References:

[1] 辛龙,俞雷钧,徐卫星,等.后路减压融合内固定结合人工椎板成形术治疗老年退行性腰椎管狭窄症的早期疗效分析[J].中国中医骨伤科杂志,2019,27(4):53-55.
[2] SUN C,WANG Z,TIAN J W,et al.Leptin-induced inflammation by activating IL-6 expression contributes to the fibrosis and hypertrophy of ligamentum flavum in lumbar spinal canal stenosis[J].Biosci Rep,2018,38(2):157-163.
[3] ERVIN R B.Prevalence of metabolic syndrome among adults 20 years of age and over,by sex,age,race and ethnicity,and body mass index:United States,2003-2006[J].Natl Health Stat Report,2009(13):1-7.
[4] SAKELLARIDIS N.The influence of diabetes mellitus on lumbar intervertebral disk herniation[J].Surg Neurol,2006,66(2):152-154.
[5] CUI G,WATANABE K,MIYAUCHI Y,et al.Matrix metalloproteinase 13 in the ligamentum flavum from lumbar spinal canal stenosis patients with and without diabetes mellitus[J].J Orthop Sci,2011,16(6):785-790.
[6] KREINER D S,SHAFFER W O,BAISDEN J L,et al.An evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spinal stenosis(update)[J].Spine J,2013,13(7):734-743.
[7] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[J].中国实用内科杂志,2018,38(4):292-344.
[8] SAKAMAKI T,SAIRYO K,SAKAI T,et al.Measurements of ligamentum flavum thickening at lumbar spine using MRI[J].Arch Orthop Trauma Surg,2009,129(10):1415-1419.
[9] GARGANO F P.Transverse axial tomography of the spine[J].CRC Crit Rev Clin Radiol Nucl Med,1976,8(3):279-328.
[10] 邢文华,郝利霞,霍洪军,等.腰椎管狭窄症椎管狭窄的MRI测量及其临床意义[J].中国临床医学影像杂志,2014,25(9):645-647.
[11] 零刚新,阮兵,古文熠.硬膜囊与椎管的面积之比的CT测量指标在椎管狭窄症的诊断价值研究[J].现代医用影像学,2016,25(2):170-173.
[12] 任少东,杨学军.退行性腰椎管狭窄症诊断与保守治疗研究进展[J].世界最新医学信息文摘,2018,18(16):106-108.
[13] 刘汝落.腰椎管狭窄症[J].中国矫形外科杂志,2004,12(19):72-74.
[14] 阚敏慧,王立功,程爱国.腰椎管狭窄症[J].中国煤炭工业医学杂志,2006,9(7):655-658.
[15] SCHROEDER G D,KURD M F,VACCARO A R.Lumbar spinal stenosis:how is it classified?[J].J Am Acad Orthop Surg,2016,24(12):843-852.
[16] LOTAN R,ORON A,ANEKSTEIN Y,et al.Lumbar stenosis and systemic diseases:is there any relevance?[J].J Spinal Disord Tech,2008,21(4):247-251.
[17] 刘建民.糖尿病性骨病[J].国外医学(内分泌学分册),2003(2):133-135.
[18] 韩松梅,陈莉丽.胰岛素与骨代谢的关系[J].海南医学,2017,28(10):1657-1660.
[19] XIONG C,HUANG Y,KANG H,et al.Macrophage inhibition factor-mediated CD74 signal modulate inflammation and matrix metabolism in the degenerated cartilage endplate chondrocytes by activating extracellular signal regulated kinase 1/2[J].Spine(Phila Pa 1976),2017,42(2):61-70.
[20] 周金军,邓琳,张烽.仰卧位腰椎MRI小关节积液对症状性腰椎管狭窄微创减压手术效果的影响[J].实用医学杂志,2018,34(14):2374-2376.
[21] MOKSHAGUNDAM S P L.Macrophage migration inhibitory factor:a potential target for diabetes prevention?[J].Am J Med Sci,2018,355(6):519-520.
[22] PARK J O,LEE B H,KANG Y M,et al.Inflammatory cytokines induce fibrosis and ossification of human ligamentum flavum cells[J].J Spinal Disord Tech,2013,26(1):6-12.
[23] SAITO T,HARA M,KUMAMARU H,et al.Macrophage infiltration is a causative factor for ligamentum flavum hypertrophy through the activation of collagen production in fibroblasts[J].Am J Pathol,2017,187(12):2831-2840.
[24] LUO J,HUANG L,CHEN Z,et al.Increased sorbitol levels in the hypertrophic ligamentum flavum of diabetic patients with lumbar spinal canal stenosis[J].J Orthop Res,2017,35(5):1058-1066.
[25] NAKAMURA T,OKADA T,ENDO M,et al.Angiopoietin-like protein 2 promotes inflammatory conditions in the ligamentum flavum in the pathogenesis of lumbar spinal canal stenosis by activating interleukin-6 expression[J].Eur Spine J,2015,24(9):2001-2009.

备注/Memo

备注/Memo:
基金项目:湖北省卫生健康科研基金资助项目(WJ2019H429, WX19B06)) 武汉市卫生健康科研基金资助项目(WX18A04) △通信作者 E-mail:zylwind@126.com(收稿日期:2019-11-01)
更新日期/Last Update: 2020-01-15