| 血清维生素D水平和肩袖撕裂修补术后疗效的相关性研究 |
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投稿时间：2021-10-02
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| 作者 | Author | 单位 | Address | E-Mail |
| 陈俊 |
CHEN Jun |
东阳市人民医院关节与运动医学科, 浙江 东阳 322100 |
Department of Joint and Sports Medicine, Dongyang People's Hospital, Dongyang 322100, Zhejiang, China |
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| 楼珏翔 |
LOU Yu-xiang |
东阳市人民医院关节与运动医学科, 浙江 东阳 322100 |
Department of Joint and Sports Medicine, Dongyang People's Hospital, Dongyang 322100, Zhejiang, China |
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| 徐国红 |
XU Guo-hong |
东阳市人民医院关节与运动医学科, 浙江 东阳 322100 |
Department of Joint and Sports Medicine, Dongyang People's Hospital, Dongyang 322100, Zhejiang, China |
dyxghd15@163.com |
| 王维凯 |
WANG Wei-kai |
东阳市人民医院关节与运动医学科, 浙江 东阳 322100 |
Department of Joint and Sports Medicine, Dongyang People's Hospital, Dongyang 322100, Zhejiang, China |
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| 期刊信息：《中国骨伤》2022年，第35卷，第3期，第225-232页 |
| DOI：10.12200/j.issn.1003-0034.2022.03.006 |
| 基金项目:浙江省医药卫生科技计划项目（编号:2021KY1190）；金华市科技局项目（编号:2020-4-136） |
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中文摘要:
目的: 探讨血清维生素D水平与肩袖撕裂修补术后临床效果的相关性。
方法: 回顾性分析自2018年3月至2020年3月，依据选择标准纳入的122例患者，术后随访12个月；其中男50例，女72例；年龄34~82（62.10±8.39）岁。将所有患者分成缺乏组（维生素D<20 μg/L）和对照组（维生素D ≥ 20 μg/L），其中缺乏组62例，维生素D（14.80±3.18） μg/L；对照组60例，维生素D（25.17±5.64） μg/L。比较两组患者年龄，性别，体质量指数（body mass index，BMI），肩袖撕裂大小，回缩程度，脂肪浸润程度，受伤因素，术后疼痛视觉模拟评分（visual analogue scale，VAS），术后肩关节功能评分，再撕裂率等指标。将所有患者年龄因素分为<60岁和 ≥ 60岁，BMI分为<24 kg/m2和 ≥ 24 kg/m2，肩袖撕裂大小分为 ≤ 3 cm和>3 cm，回缩程度分为 ≤ 2 cm和>2 cm，脂肪浸润因素分为 ≤ 2级和>2级，病程因素分为 ≤ 3个月和>3个月，分析Sugaya再撕裂类型与上述变量之间的相关性。
结果: 122例完成随访，未出现关节感染、锚钉退出、翻修手术等严重并发症。两组患者年龄、性别、BMI、肩袖撕裂大小、受伤因素、回缩程度、脂肪浸润程度、病程比较差异无统计学意义（P>0.05）。两组术后肩关节功能评分差异无统计学意义（P>0.05）。两组患者术后1、3个月VAS差异有统计学意义，维生素D缺乏组更高，术后6、12个月时差异无统计学意义。选取年龄、维生素D是否缺乏、撕裂大小、回缩程度、脂肪浸润作为自变量，肩袖术后是否再撕裂作为因变量，发现肩袖撕裂大小（>3 cm）、脂肪浸润程度（>2级）、回缩程度（>2 cm）是肩袖术后再撕裂的危险因素（P<0.05），而年龄、维生素D缺乏与肩袖术后再撕裂无显著相关性（P>0.05）。维生素D缺乏组和对照组之间的肩袖术后再撕裂Sugaya 分类（Ⅰ-Ⅴ级）差异有统计学意义（t=14.228，P=0.007）。
结论: 维生素D缺乏与肩袖术后功能恢复、再撕裂率无关，但可增加术后早期疼痛，并影响肩袖术后再撕裂的Sugaya分级。 |
| 【关键词】维生素D 肩关节 关节镜 治疗结果 |
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| Study on correlation between serum vitamin D level and the curative effect after repair of rotator cuff tears |
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ABSTRACT
Objective: To investigate the correlation between serum vitamin D level and clinical outcomes after repair of rotator cuff tears.
Methods: A total 122 patients who met the inclusion criteria and were followed up for 12 months from March 2018 to March 2020 were analyzed retrospectively,including 50 males and 72 females with an average age of(62.10±8.39) years old (ranged,34 to 82 years old). All patients were divided into deficiency group(vitamin D<20 μg/L) and control group(vitamin D ≥ 20 μg/L),including 62 cases in the deficiency group,with vitamin D (14.80±3.18) μg/L;60 cases in the control group,with vitamin D(25.17±5.64) μg/L. The two groups were compared in terms of age,gender,body mass index(BMI),tear size,degree of retraction,degree of fatty infiltration,injury factors,postoperative pain VAS score,postoperative shoulder joint function score,and re-tear rate. The age of all patients was divided into two categories:<60 years old and ≥ 60 years old;BMI was divided into <24 kg/m2 and ≥ 24 kg/m2;tear size was divided into ≤ 3 cm and >3 cm;retraction degree was divided into ≤ 2 cm and >2 cm;fat infiltration was divided into ≤ 2 grade and >2 grade;and the course of the disease was ≤ 3 months and >3 months. The correlation between Sugaya re-tear type and the variables listed above were analyzed and calculated.
Results: There were no major complications such as joint infection,anchor withdrawal and revision surgery in any of the 122 patients who were followed up on. There were no statistical differences in age,gender,injury factor,BMI,tear size,degree of retraction,degree of fatty infiltration,and duration of disease between the two groups (P>0.05). The Constant-Murley scores,UCLA scores,and ASES scores of the two groups all improved considerably after surgery(P<0.05);however,there was no statistical differences in the postoperative shoulder function scores between the two groups (P>0.05). There was significant difference in VAS between the two groups 1 month and 3 months after operation,with vitamin D deficiency group scoring higher,and there was no significant differences 6 and 12 months after operation. Tear size(>3 cm),degree of retraction(>2 cm),degree of fatty infiltration(>2 degree) were all shown to be the independent risk factors for retear after surgery by Logistic regression analysis(P<0.05). The comparison between the two groups of patients using a 2×5 row list showed that the Sugaya classification of rotator cuff re-tear(grade Ⅰto Ⅴ) between the vitamin D deficiency group and the control group was statistically different(t=14.228,P=0.007). It was discovered that the Sugaya classification after surgery was statistically different between the two groups.
Conclusion: Vitamin D deficiency is not correlated with clinical function scores and re-tear rate,however it is associated with the early postoperative pain (1 and 3 months) and the quality of rotator cuff healing (Sugaya classification) after surgery. |
| KEY WORDS Vitamin D Shoulder joint Arthroscopes Treatment outcome |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 陈俊,楼珏翔,徐国红,王维凯.血清维生素D水平和肩袖撕裂修补术后疗效的相关性研究[J].中国骨伤,2022,35(3):225~232 |
| 英文格式: | CHEN Jun,LOU Yu-xiang,XU Guo-hong,WANG Wei-kai.Study on correlation between serum vitamin D level and the curative effect after repair of rotator cuff tears[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(3):225~232 |
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