多维度胫骨结节参数预测髌骨不稳的临床价值研究

罗文礼; 张嗣晓; 应吕方; 吴鸯鸯

doi:10.16766/j.cnki.issn.1674-4152.003455

多维度胫骨结节参数预测髌骨不稳的临床价值研究

doi: 10.16766/j.cnki.issn.1674-4152.003455

1.
宁波市杭州湾医院骨科，浙江宁波 315336
2.
宁波市杭州湾医院消毒供应中心

基金项目:

浙江省中医药科技计划项目 2020ZB231

宁波市医学科技计划项目 2020Y86

详细信息

通讯作者:
罗文礼，E-mail：luowenli0617@163.com

中图分类号: R682.6
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- 文章访问数: 57
- HTML全文浏览量: 16
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2023-12-08
- 网络出版日期: 2024-05-29

Value of multidimensional tibial tuberosity parameters in predicting patellar instability

1.
Department of Orthopedics, Ningbo Hangzhou Bay Hospital, Ningbo, Zhejiang 315336, China

摘要

摘要: 目的本研究旨在通过测量多维度胫骨结节(TT)参数，评估多项TT参数在预测患者髌骨不稳的诊断效能。方法选择2020年1月—2023年1月在宁波市杭州湾医院骨科门诊接受膝关节CT并确诊为髌骨不稳的患者为观察组，同时随机选取同期接受膝关节CT但排除髌骨不稳的患者作为对照组，各45例。统计患者资料并通过logistic回归及ROC曲线分析各项TT参数的临床诊断效能。结果共纳入符合标准的患者90例，其中男性33例，女性57例。2组性别比较差异无统计学意义，观察组年龄相对较轻，差异有统计学意义(P < 0.001)。Logistic回归分析显示，TT-TG、TT-RA、TT-TG/PL、TT-TG/PTL相关TT参数是预测髌骨不稳的有效指标。同时ROC曲线分析表明各项TT参数的诊断效能，其中TT-TG/PL的AUC值为0.826，TT-TG的AUC为0.816，TT-RA的AUC为0.761，TT-TG/PTL的AUC为0.769。结论多维度TT参数如TT-TG、TT-RA、TT-TG/PL、TT-TG/PTL，在预测髌骨不稳方面具有良好的临床应用价值。鉴于单一量化指标可能无法全面评估髌骨不稳，结合多个维度的TT参数可以提供更全面和精确的评估，从而为患者的早期诊断与治疗决策提供科学依据。
- 髌骨不稳 /
- TT-TG /
- TT-TG/PL /
- TT-RA /
- 预测价值
Abstract: Objective To analyze the diagnostic efficiency of various multidimensional tibial tuberosity (TT) parameters in patellar instability, revealing their clinical applicability. Methods Patients diagnosed with patellar instability who underwent knee joint CT scans at Ningbo Hangzhou Bay Hospital from January 2020 to January 2023 were included as the observation group. A control group was randomly selected from patients who underwent knee joint CT scans during the same period but were excluded for patellar instability. Each group comprised 45 cases. Patient data were collected, and the clinical diagnostic efficiency of various TT parameters was analyzed through logistic regression and ROC curve analysis. Results A total of 90 eligible patients were included, with 33 males and 57 females. There was no significant difference in gender distribution between the two groups, but the observation group had a significantly younger age with statistical significance (P < 0.001). Logistic regression analysis showed that TT-TG, TT-RA, TT-TG/PL, and TT-TG/PTL related TT parameters were effective indicators for predicting patellar instability. At the same time, ROC curve analysis indicated the diagnostic efficacy of the related TT parameters, with the AUC value of TT-TG/PL being 0.826, TT-TG 0.816, TT-RA 0.761, and TT-TG/PTL 0.769. Conclusion Multidimensional TT parameters, such as TT-TG, TT-RA, TT-TG/PL, and TT-TG/PTL, have good clinical value in predicting patellar instability. Given that a single quantitative indicator may not fully assess patellar instability, combining multiple dimensional TT parameters can provide a more comprehensive and precise evaluation, thereby offering early guidance for the diagnosis and treatment of patellar instability.
- Patellar instability /
- TT-TG /
- TT-TG/PL /
- TT-RA /
- Predictive value

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图 1 行膝关节CT检查者各项测量指标的ROC曲线

Figure 1. ROC curves of various measurements in patients undergoing CT examination of knee joint

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表 1 2组行膝关节CT检查者临床资料比较

Table 1. Comparison of clinical data of 2 groups who underwent knee joint CT examination

组别	例数	年龄 (x±s，岁)	性别[例(%)]		TT-TG (x±s，mm)	TT-TE (x±s，mm)	TT-RA (x±s，mm)	TT-TG/PL (x±s)	TT-TG/PTL (x±s)
组别	例数	年龄 (x±s，岁)	女性	男性	TT-TG (x±s，mm)	TT-TE (x±s，mm)	TT-RA (x±s，mm)	TT-TG/PL (x±s)	TT-TG/PTL (x±s)
观察组	45	18.63±4.7	27(60.00)	18(40.00)	25.18±6.86	62.77±5.45	18.24±5.56	0.87±0.24	0.61±0.16
对照组	45	28.55±5.6	30(66.67)	15(33.34)	12.75±5.42	63.89±6.21	12.59±3.16	0.33±0.12	0.40±0.17
统计量		0.779^a	0.431^b		7.763^a	4.345^a	5.428^a	8.014^a	7.245^a
P值		< 0.001	0.512		< 0.001	0.786	0.024	< 0.001	0.015
注：^a为t值，^b为χ²值。

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表 2 行膝关节CT检查者髌骨稳定性影响因素logistic回归分析

Table 2. Logistic regression analysis of influencing factors of patellar stability in patients undergoing knee CT

变量	B	SE	Waldχ²	P值	OR值	95% CI
TT-TG	2.267	0.890	8.034	0.005	9.647	2.012~46.245
TT-RA	1.241	0.653	4.901	0.027	3.461	1.153~10.388
TT-TG/PL	0.175	0.177	9.397	0.002	1.191	1.065~1.332
TT-TG/PTL	0.138	0.736	4.309	0.038	1.148	1.008~1.307

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表 3 行膝关节CT检查者各项测量指标诊断效能比较

Table 3. Comparison of diagnostic efficacy of various measurement indexes in patients undergoing knee joint CT examination

变量	AUC	P值	95% CI	灵敏度 (%)	特异度 (%)	截断值
TT-TG	0.816	< 0.001	0.716~0.893	78.05	80.49	21.03 mm
TT-RA	0.761	< 0.001	0.655~0.849	80.50	63.40	23.12 mm
TT-TG/PL	0.826	< 0.001	0.726~0.901	78.00	80.50	0.564
TT-TG/PTL	0.769	< 0.001	0.662~0.855	68.30	80.50	0.298

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