刘坤,胡柳,方婷,等.武汉市汉阳区中学生脊柱侧凸现状及轴向躯干旋转角与Cobb角的相关性分析[J].中华物理医学与康复杂志,2025,47(7):614-618
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| 武汉市汉阳区中学生脊柱侧凸现状及轴向躯干旋转角与Cobb角的相关性分析 |
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| DOI：10.3760/cma.j.cn421666-20241106-00890 |
| 中文关键词: 脊柱侧凸 轴向躯干旋转角 Cobb角 中学生 筛查 |
| 英文关键词: Scoliosis Axial trunk rotation angle Cobb angle Screening Middle school students |
| 基金项目:湖北省卫生健康科技项目(WJ2025ZH028) |
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| 中文摘要: |
| 目的 通过入校筛查了解武汉市汉阳区中学生脊柱侧凸患病情况，并探讨不同性别、年龄、体重指数(BMI)及分型的脊柱侧凸中学生其轴向躯干旋转角(ATR)与Cobb角间的相关性，为脊柱侧凸的早期防治提供参考资料。 方法 于2023年8月至12月期间，采用随机整群抽样方法抽取武汉市汉阳区11所中学学校共9501名中学生作为观察对象，采用六步筛查法、前屈试验、躯干旋转测量仪和X线检查对其进行脊柱侧凸筛查；并按照性别、年龄、BMI、侧凸类型等对脊柱侧凸中学生进行分组，分别计算各组中学生ATR与Cobb角间的相关性。 结果 武汉市汉阳区11所中学共检出脊柱侧凸中学生358人，筛查阳性率为3.77%，其中男生150人，女生208人，女生筛查阳性率（4.75%）较男生筛查阳性率（2.93%）显著提高（P＜0.05）。通过Spearman相关性分析发现，358名脊柱侧凸中学生的ATR与Cobb角间存在中度相关性（r值为0.692，P＜0.05）；在性别方面，发现男生、女生ATR与Cobb角间均存在正相关性（r值分别为0.688和0.700，均P＜0.05）；在年龄方面，13岁、14岁、15岁、16岁学生的ATR与Cobb角间均存在正相关性（r值分别为0.553、0.686、0.729和0.764，均P＜0.05）；在BMI方面，低体质量组、正常组、超重组的ATR与Cobb角间均存在正相关性（r值分别为0.755、0.677和0.633，均P＜0.05），肥胖组的ATR与Cobb角间无显著相关性（r值为0.364，P＞0.05）；在侧凸分型方面，发现Ⅰa型、Ⅰb型、Ⅰc型、Ⅱa型、Ⅱb型、Ⅱc型及Ⅱd型中学生的ATR与Cobb角间均存在正相关性（r值分别为0.731、0.717、0.696、0.523、0.519、0.498和0.509，均P＜0.05），Ⅲ型中学生的ATR与Cobb角间无显著相关性（r值为0.514，P＞0.05）。 结论 脊柱侧凸是青少年常见的脊柱畸形疾病之一，社会、学校及家长应充分重视青少年脊柱侧凸的早防、早诊、早治，尤其需多关注女生群体；ATR可在一定程度上反映Cobb角大小，对于单弯、双弯类型脊柱侧凸患者可采用ATR进行筛查，对于三弯或肥胖患者，ATR筛查可能存在一定假阴性结果，需结合其他手段辅助诊断。 |
| 英文摘要: |
| Objective To investigate the prevalence of scoliosis among middle school students through school-based screening, and to analyze the correlations between axial trunk rotation (ATR) angle and Cobb angle among those with scoliosis considering gender, age, body mass index (BMI) and curve type, so as to provide references for early prevention and treatment. Methods Random cluster sampling was used to enroll 9501 middle school students from 11 schools in the Hanyang District of Wuhan. They underwent a six-step scoliosis screening with a forward bending test, scoliometer measurements, and confirmatory X-ray examinations. The students exhibiting scoliosis were stratified by gender, age, BMI, and curve type. The correlation between ATR angle and Cobb angle was subsequently analyzed within each subgroup. Results Scoliosis was observed in 358 of the students (150 boys and 208 girls), a positive screening rate of 3.8%. Moreover, the positive screening rate was significantly higher among the girls (4.8%) than among the boys (2.9%). There was a moderate Spearman correlation (r=0.69) between the ATR and Cobb angles in 358 of the students with scoliosis, both the boys (r=0.69) and the girls (r=0.70). When it came to age, there was a positive correlation between the ATR and Cobb angles for students aged 13 to 16 irrespective of their BMI classification, except that there was no significant correlation between the two angles for those classified as obese. In terms of Peking Union Medical College (PUMC) classification, there was a positive correlation for those in types Ia, Ib, Ic, IIa, IIb, IIc and IId, but there was no significant correlation between the two angles for those in type III. Conclusions Scoliosis is prevalent among the group of adolescents studied. Society, schools and parents need to prioritize prevention, heightened awareness, timely diagnosis and early treatment, particularly for girls. The ATR angle may serve as a practical surrogate for estimating Cobb angle severity in scoliosis screening for single-curve or double-curve cases. However, ATR measurements may yield false-negative results among those with triple-curve deformities or the obese, underscoring the need for supplementary diagnostic methods among such populations. |
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