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目的 :探讨Ⅱ型糖尿病(DM)与腰椎间盘退变的相关性。方法 :选择2013年因腰腿痛至我院脊柱外科门诊就诊并满足入选标准的390例50~60岁患者,详细记录患者DM病史,其中非DM患者123例(非DM组)、血糖控制较好患者140例(A组),血糖控制较差DM患者127例(B组);A组中DM≤10年68例(A1组),DM>10年72例(A2组);B组中DM≤10年60例(B1组),DM>10年67例(B2组)。用Pfirrmann评分系统对各组患者各节段腰椎间盘退变程度进行评分,用SPSS 19.0统计分析DM与腰椎间盘退变程度的相关性。结果:各组资料均服从正态分布(P>0.05)。各组间一般资料无显著性差异(P>0.05)。在L1/2~L5/S1每节段上,A1组Pfirrmann评分与非DM组无显著性差异(P>0.05);A2、B1及B2组的Pfirrmann评分显著高于非DM组(P<0.05)。A2、B2组Pfirrmann评分显著较A1、B1组高(P<0.05);B1、B2组Pfirrmann评分均较A1、A2组高(P<0.05)。在A、B组中,L1/2~L5/S1每一节段上腰椎间盘退变程度与DM病程呈显著性正相关(P<0.05)。结论 :DM>10年及血糖控制不良是腰椎间盘退变的危险因素,腰椎间盘退变程度与DM病程呈正相关。
Objective: To investigate the relationship between type 2 diabetes (DM) and lumbar disc degeneration. Methods: A total of 390 patients (50-60 years old) with low back and leg pain due to low back and leg pain in the department of spine surgery in our hospital who met the inclusion criteria were enrolled in this study. The DM history was recorded in detail. 123 non-DM patients (non-DM group) A group of 140 patients (group A), poor blood glucose control DM patients with 127 cases (group B); A group of DM≤10 years in 68 cases (group A1), DM> 10 years in 72 cases (group A2) DM ≤ 10 years in 60 cases (group B1), DM> 10 years in 67 cases (group B2). The degree of lumbar disc degeneration in each group was scored by Pfirrmann scoring system. The correlation between DM and lumbar disc degeneration was analyzed by SPSS 19.0. Results: The data of all groups obey normal distribution (P> 0.05). There was no significant difference between the groups (P> 0.05). The Pfirrmann score of A1, T2 and B2 groups was significantly higher than that of non-DM group (P <0.05) in L1 / 2 ~ L5 / S1 per segment ). The Pfirrmann scores of A2 and B2 groups were significantly higher than those of A1 and B1 groups (P <0.05). The Pfirrmann scores of B1 and B2 groups were higher than those of A1 and A2 groups (P <0.05). In group A and group B, the degenerative degree of lumbar intervertebral disc in each segment of L1 / 2 ~ L5 / S1 was positively correlated with the course of DM (P <0.05). Conclusion: DM> 10 years and poor glycemic control are the risk factors of lumbar disc degeneration. The degree of lumbar disc degeneration is positively correlated with the course of DM.