[摘要] 目的 分析绝经期女性骨质疏松合并腰椎退行性病变的危险因素。方法 选取2022年11月至2024年11月于台州市中心医院就诊的108例绝经期女性骨质疏松症患者，根据X线正侧位检查将患者分为合并腰椎退行性病变患者（研究组，n=31）和未合并腰椎退行性病变患者（对照组，n=77），采用Logistic回归分析探讨影响绝经期女性骨质疏松合并腰椎退行性病变的相关因素，绘制受试者操作特征曲线分析影响因素的诊断价值。结果 脊柱后凸畸形、白细胞介素（interleukin，IL）-17、β胶原特殊序列（beta C-terminal cross-linked telopeptides of type Ⅰ collagen，β-CTX）水平及骨密度T值是影响绝经期女性骨质疏松合并腰椎退行性病变的相关因素（Plt;0.05）；研究组患者脊柱后凸畸形占比64.52%、血清IL-17（142.71±18.23）pg/ml、血清β-CTX（0.75±0.02）ng/ml均高于对照组[38.96%、（129.63±15.46）pg/ml、（0.54±0.08）ng/ml]；骨密度T值（–3.94±0.28）低于对照组（–3.15±0.26），组间比较差异有统计学意义（Plt;0.05）；脊柱后凸畸形、血清IL-17、血清β-CTX水平和骨密度T值联合诊断价值最高，曲线下面积为0.903（95%CI：0.854～0.952）。结论 脊柱后凸畸形、血清IL-17、血清β-CTX水平及骨密度T值均为绝经期女性骨质疏松合并腰椎退行性病变的影响因素且联合诊断价值最高。

[关键词] 绝经期女性；骨质疏松；腰椎退行性病变；骨密度；脊柱后凸畸形；β胶原特殊序列

[中图分类号] R711.51；R681.5" """"[文献标识码] A""" [DOI] 10.3969/j.issn.1673-9701.2025.18.009

Risk factors analysis of osteoporosis combined with lumbar degenerative diseases in menopausal women

YAO Binbin， YANG Jiahui

Department of Orthopedics， Taizhou Central Hospital， Taizhou University Hospital， Taizhou 318000， Zhejiang， China

[Abstract] Objective To analyze the risk factors of osteoporosis combined with lumbar degenerative diseases in menopausal women. Methods A total of 108 menopausal women with osteoporosis treated at Taizhou Central Hospital were selected from November 2022 to November 2024. According to X-ray anteroposterior and lateral examinations， they were divided into study group （n=31） with lumbar degenerative lesions and control group （n=77） without. Logistic regression analyzed related factors， and receiver operating characteristic curve evaluated diagnostic values. Results Kyphosis， interleukin （IL）-17， beta C-terminal cross-linked telopeptides of type Ⅰ collagen （β-CTX） levels， and bone density T values were related factors （Plt;0.05）. Kyphosis deformity accounted for 64.52%， serum IL-17 with （142.71±18.23） pg/ml and serum β-CTX with （0.75±0.02） ng/ml in study group were higher than those in control group [38.96%， （129.63±15.46） pg/ml and （0.54±0.08） ng/ml]， the T value of bone mineral density with （–3.94±0.28） was lower than that in control group with （–3.15±0.26）， and there were statistical differences between two groups （Plt;0.05）. The combined diagnostic value of kyphosis， serum IL-17， β-CTX levels， and bone density T value is the highestt， with an area under the curve of 0.903 （95%CI： 0.854-0.952）. Conclusion Kyphosis， serum IL-17， β-CTX levels and bone mineral density T value are all the influencing factors of osteoporosis combined with lumbar degenerative diseases in menopausal women， and the combined diagnosis value is the highest.

[Key words] Menopausal women; Osteoporosis; Lumbar degenerative disease; Bone density; Kyphosis deformity; Beta C-terminal cross-linked telopeptides of type Ⅰ collagen

骨质疏松是以骨量低、骨组织微结构损坏致骨脆性增加、易骨折为特征的全身性骨病^[1]。骨质疏松病变广泛，其中椎体受累引发的形态与力学改变可加速腰椎退行性病变，导致椎间盘退变、骨质增生及骨折等并发症频发，降低患者的生活质量^[2]。骨质疏松患者常合并腰椎间盘突出、滑脱、退行性侧凸等脊柱退行性疾病，干扰骨密度检测的准确性，增加诊疗难度^[3-4]。……