[1]王亚芬,韩桃丽,谢晓聪,等.血清雌二醇、骨密度对绝经后脊柱退行性疾病患者术后预后不良的预测价值[J].陕西医学杂志,2026,(8):1070-1074.[doi:DOI:10.3969/j.issn.1000-7377.2026.08.009]
　WANG Yafen,HAN Taoli,XIE Xiaocong,et al.Predictive value of serum estradiol and bone mineral density for poor postoperative prognosis in postmenopausal patients with degenerative spinal diseases[J].,2026,(8):1070-1074.[doi:DOI:10.3969/j.issn.1000-7377.2026.08.009]
点击复制

血清雌二醇、骨密度对绝经后脊柱退行性疾病患者术后预后不良的预测价值

《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2026年8期
页码:
1070-1074
栏目:
临床研究
出版日期:
2026-08-05

文章信息/Info

Title:
Predictive value of serum estradiol and bone mineral density for poor postoperative prognosis in postmenopausal patients with degenerative spinal diseases
作者:
王亚芬; 韩桃丽; 谢晓聪; 姚静; 马辉; 解国辉
（山西医科大学附属运城市中心医院脊柱外科，山西 运城 044000）
Author(s):
WANG Yafen; HAN Taoli; XIE Xiaocong; YAO Jing; MA Hui; XIE Guohui
(Department of Spine Surgery,Yuncheng Central Hospital Affiliated to Shanxi Medical University,Yuncheng 044000,China)
关键词:
脊柱退行性疾病; 绝经后女性; 雌二醇; 骨密度; 预后; 预测价值
Keywords:
Degenerative spinal diseases; Postmenopausal women; Estradiol; Bone mineral density; Prognosis; Predictive value
分类号:
R 681.5
DOI:
DOI:10.3969/j.issn.1000-7377.2026.08.009
文献标志码:
A
摘要:
目的：探讨血清雌二醇（E2）、骨密度（BMD）对绝经后脊柱退行性疾病患者术后预后不良的预测价值。方法：选取186例行手术治疗的绝经后脊柱退行性疾病患者，根据术后12个月Oswestry功能障碍指数（ODI）评分分为预后良好组（ODI≤20分，112例）和预后不良组（ODI>20分，74例）。比较两组患者临床资料、血清E2水平及腰椎、髋部BMD。采用多因素Logistic回归分析绝经后脊柱退行性疾病患者术后预后不良的影响因素。绘制受试者工作特征（ROC）曲线，计算曲线下面积（AUC），评估血清E2、腰椎及髋部BMD对患者术后预后不良的预测价值。结果：两组患者体重指数（BMI）、手术部位、手术时间、术中出血量比较差异无统计学意义（均P＞0.05）。与预后良好组比较，预后不良组患者年龄更高，绝经年限更长，手术节段≥3个、复杂术式、术后矢状位垂直轴（SVA）>50 mm比例升高（均P＜0.05）。与预后良好组比较，预后不良组患者血清E2水平降低，腰椎及髋部BMD T值低于预后良好组（均P＜0.05）。年龄、手术节段数量、手术方式、术后SVA、血清E2、腰椎BMD T值、髋部BMD T值是绝经后脊柱退行性疾病患者术后预后不良的独立影响因素（均P<0.05）。血清E2、腰椎BMD T值、髋部BMD T值联合预测患者术后预后不良的AUC高于单一指标预测的AUC（均P<0.05）。结论：血清E2、腰椎及髋部BMD是绝经后脊柱退行性疾病患者术后预后不良的影响因素，三者联合检测对患者术后预后不良的预测价值较高。
Abstract:
Objective:To investigate the predictive value of serum estradiol (E2) and bone mineral density (BMD) for poor postoperative prognosis in postmenopausal patients with degenerative spinal diseases.Methods:A total of 186 postmenopausal patients with degenerative spinal diseases who received surgical treatment were enrolled.According to the Oswestry Disability Index (ODI) score at 12 months after surgery,patients were divided into the good prognosis group (ODI≤20 points,112 cases) and the poor prognosis group (ODI>20 points,74 cases).Clinical data,serum E2 levels,lumbar BMD and hip BMD were compared between the two groups.Multivariate Logistic regression analysis was performed to identify the influencing factors of poor postoperative prognosis in postmenopausal patients with degenerative spinal diseases.ROC curves were plotted,and the AUC was calculated to evaluate the predictive value of serum E2,lumbar BMD and hip BMD for poor postoperative prognosis.Results:There were no statistically significant differences in body mass index (BMI),surgical site,operation duration and intraoperative blood loss between the two groups (all P>0.05).Compared with the good prognosis group,patients in the poor prognosis group were older with longer postmenopausal years,and had higher proportions of ≥3 surgical segments,complex surgical procedures and postoperative sagittal vertical axis (SVA)>50 mm (all P<0.05).The serum E2 level,lumbar BMD T-score and hip BMD T-score in the poor prognosis group were significantly lower than those in the good prognosis group (all P<0.05).Age,number of surgical segments,surgical approach,postoperative SVA,serum E2,lumbar BMD T-score and hip BMD T-score were independent influencing factors for poor postoperative prognosis in postmenopausal patients with degenerative spinal diseases (all P<0.05).The AUC of combined detection of serum E2,lumbar BMD T-score and hip BMD T-score for predicting poor postoperative prognosis was higher than that of each single indicator (all P<0.05).Conclusion:Serum E2,lumbar BMD and hip BMD are influencing factors for poor postoperative prognosis in postmenopausal patients with degenerative spinal diseases,and the combined detection of the three indicators exhibits high predictive value for poor postoperative prognosis.

参考文献/References:

[1]吴爱玲,石小红,尹雪,等.女性退行性腰椎滑脱症患者雌激素受体基因多态性与腰背痛强度的相关性[J].颈腰痛杂志,2022,43(4):558-560.
[2]LEE Z H,TUNG W S,SANTHIRAN K A J,et al.Estrogen hindrance escalates inflammation and neurodegeneration in the hippocampal regions of collagen-induced arthritis female Sprague-Dawley rats[J].Pflugers Arch,2025,477(2):317-332.
[3]郭贵宏.绝经后女性骨质疏松与腰椎椎旁肌的关系研究[D].呼和浩特:内蒙古医科大学,2021.
[4]RASHIDI E,TEHRANI F R,VALIZADEH M,et al.Association between lifetime endogenous estrogen exposure and body composition metrics in postmenopausal women:Findings from the Tehran Lipid and Glucose Study[J].BMC Womens Health,2024,24(1):648.
[5]彭玉,梅伟群,李志琛,等.重组人甲状旁腺激素(1-34)联合雌激素对绝经后骨质疏松患者骨代谢和炎症反应的改善效果[J].中国妇幼保健,2022,37(20):3725-3728.
[6]LI G,WANG A,TANG W,et al.Progranulin deficiency associates with postmenopausal osteoporosis via increasing ubiquitination of estrogen receptor α[J].Genes Dis,2024,12(1):101221.
[7]赵梦幻,宋蕾,周昆,等.ERα介导破骨细胞分化防治绝经后骨质疏松症研究进展[J].中国骨质疏松杂志,2025,31(10):1484-1489.
[8]柴爽,马江涛,杨岩冰,等.雌激素受体在骨疏康治疗绝经后骨质疏松症中的作用与机制[J].中国组织工程研究,2024,28(16):2574-2578.
[9]赵帅.绝经后雌激素及炎症因子与腰椎间盘退变的相关性研究[D].呼和浩特:内蒙古医科大学,2023.
[10]曹飞,姚佩恒,苗晋军,等.腰椎邻近节段退行性疾病行延长融合节段翻修手术后置入物相关并发症的危险因素[J].脊柱外科杂志,2025,23(1):35-39.
[11]谭东,谭建,何鑫.血清铁蛋白、雌激素水平与绝经后骨质疏松症患者骨代谢相关指标的关系[J].实用预防医学,2025,32(9):1130-1132.
[12]HUQ A M,STANSLAS J,NIZHUM N,et al.Estrogenic post-menopausal anti-osteoporotic mechanism of Achyranthes aspera L.:Phytochemicals and network pharmacology approaches[J].Heliyon,2024,10(20):e38792.
[13]王瑞.选择性雌激素受体调节剂治疗绝经后女性骨质疏松症的效果及骨代谢指标研究[J].医学理论与实践,2025,38(15):2603-2605.
[14]MEDA C,BENEDUSI V,CHERUBINI A,et al.Hepatic estrogen receptor alpha drives masculinization in post-menopausal women with metabolic dysfunction-associated steatotic liver disease[J].JHEP Rep,2024,6(10):101143.
[15]向小蝶,李聪.雌激素缺乏导致女性骨质疏松的研究进展[J].现代医药卫生,2025,41(8):1946-1949.
[16]蔡诗雅,胡云秋,王雅,等.绝经后妇女骨密度、骨面积与椎体骨折的相关性分析[J].中华骨质疏松和骨矿盐疾病杂志,2023,16(3):216-222.
[17]唐珍珍,陈霞,张雪梅.绝经后骨质疏松症患者椎体压缩性骨折发生现状、危险因素及干预对策分析[J].中外医疗,2024,43(31):44-47.
[18]严坤,杨晓辉,王建,等.绝经后女性雌激素及炎症因子对膝关节骨性关节炎的影响[J].新疆医学,2023,53(7):787-789,799.
[19]瞿霖,赵梦幻,王冬玉,等.雌激素受体α在绝经后骨质疏松中的研究进展及作用机制[J].中国骨质疏松杂志,2024,30(7):1021-1027.
[20]蒋召磊,刘春慧,马建超,等.内分泌治疗绝经后乳腺癌继发骨质疏松症的研究进展[J].中国骨质疏松杂志,2024,30(2):234-239.
[21]张建利.雌激素相关基因变异和类雌激素金属交互作用与骨质疏松症患病风险的关联研究[D].武汉:华中科技大学,2024.
[22]赵振.雌激素受体GPR30通过抑制铁死亡和滑膜炎症用于骨性关节炎治疗及其机制研究[D].西安:中国人民解放军空军军医大学,2024.
[23]荣雪芹,罗启鹏,邹海涛,等.核心肌群训练在退行性腰椎滑脱病人脊柱内镜减压术后快速康复中的临床疗效观察[J].中国疼痛医学杂志,2021,27(7):510-515.
[24]CHEUNG S M,CHAN K S,ZHOU W,et al.Author correction:Spatial heterogeneity of peri-tumoural lipid composition in postmenopausal patients with oestrogen receptor positive breast cancer[J].Sci Rep,2024,14(1):10332.
[25]吴李红.绝经后女性骨质疏松骨折危险因素分析及预测模型构建[D].成都:成都医学院,2024.

相似文献/References:

[1]肖东波.不保留小关节植骨床PLIF术治疗老年脊柱退行性疾病价值研究*[J].陕西医学杂志,2019,(2):189.
　XIAO Dongbo..The value of nonreserving small arthroplasty bone PLIF for senile spinal degenerative diseases[J].,2019,(8):189.

备注/Memo

备注/Memo:
山西省重点研发计划项目（2023SXZ-12053）
更新日期/Last Update: 2026-08-13