目的探讨骨质疏松性胸腰椎骨折伤椎骨造影的弥漫度与VDR基因多态性的关联性。方法对60例骨质疏松性胸腰椎骨折的患者采用经皮椎体成形术治疗,术前抽取患者外周血进行VDR基因型检测,术中观察患者骨造影剂弥散分布情况、骨水泥在椎体内弥散及渗漏等情况,然后分析伤椎骨造影剂弥漫分布情况与VDR基因型的关联性。结果60例患者中检测到VDR基因BB型0例,Bb型28例,bb型32例。骨造影剂在椎体内弥散情况良好,60例共110个伤椎中85个椎体弥散超过椎体中线,其中Bb型患者占52个椎体、bb型患者占33个椎体,不同基因型患者间造影剂弥散度比较差异有统计学意义(P<0.01);有9个椎体发生了骨水泥渗漏,但均无椎管内渗漏,未发生明显并发症,其中Bb型患者占7个椎体、bb型患者占2个椎体,不同基因型患者间骨水泥渗漏情况比较,差异无统计学意义(P>0.05)。结论骨造影剂在骨质疏松性胸腰椎骨折伤椎中的弥散度与VDR基因多态性有一定关联,Bb基因型患者造影剂弥漫更充分,但同时Bb基因型患者伤椎发生骨水泥渗漏的比例也较高。
ObjectiveTo research the correlation of injured vertebral angiography dispersity and VDR gene polymorphisms in osteoporotic thoracolumbar fracture. MethodA total of 60 cases with osteoporotic thoracolumbar fracture, treatment with percutaneous vertebroplasty. Preoperative, detect system for VDR genotypes of peripheral blood in patients. Intraoperative, watch bone contrast agents were dispersed in patients and watch bone cement dispersion in vertebral body and leakage, and so on,then studied the correlation of injured vertebral angiography dispersity and VDR gene polymorphisms. ResultsSystem detected in 60 patients with VDR genotype BB 0 cases, Bb 28 cases, bb 32 cases. Injured vertebral angiography dispersion was in good condition.In 60 cases of 110 injured vertebrals,85 vertebrals were all the dispersion, VDR genotype Bb 52cases, bb 33 cases.The degree of contrast between different genotypes in patients with diffuse comparative difference was statistically significant (P<0.01).There are 9 vertebral bodys bone cement leakage happened.However, no spinal canal leakage, and no obvious complication happens. In which the VDR genotype Bb 7 cases, bb 2 cases. Between the different genotypes in patients with bone cement leakage was no statistical significance (P>0.05). ConclusionThere are certain correlation in injured vertebral angiography dispersity and VDR gene polymorphisms in Osteoporotic thoracolumbar fracture. In Bb genotype,the contrast agents are more fully , and the ratio of bone cement leakage is higher also.