目的:建立适合正常汉族青少年骨盆矢状面参数的参考值范围,分析影响骨盆矢状面形态的因素,探讨骨盆矢状面平衡及代偿的机制。方法:2007年9月~2011年7月收集171例正常汉族青少年,男87例,女84例;年龄10~17岁,平均13.1±2.0岁。在站立位全脊柱侧位X线片上测量骨盆入射角(pelvic incidence,PI)、骶骨倾斜角(sacral slope,SS)和骨盆倾斜角(pelvic tilt,PT),并计算PT/PI和SS/PI。根据年龄分为2组,低龄组10~13岁(平均11.7±1.1岁),高龄组14~17岁(平均15.0±1.1岁)。各骨盆参数组内、组间比较采用独立样本t检验或秩和检验,并将其与年龄行相关分析。本研究PI值与既往文献比较采用单样本t检验。结果:两组的PI、PT和SS在男性和女性间均无显著性差异(P〉0.05)。低龄组PI和PT显著小于高龄组(P〈0.05);低龄组SS与高龄组比较无显著性差异(P〉0.05);两组PT/PI均〈0.5,SS/PI均〉0.5。在所有青少年中(10~17岁)及低龄组中PI和PT与年龄均存在显著相关性(10~17岁者:r=0.243,r=0.371;低龄组:r=0.229,r=0.231)(P〈0.05),但在高龄组中不存在相关性(r=0.072,r=0.190,P〉0.05);低龄组、高龄组及10~17岁者SS与年龄军无显著相关性(P〉0.05)。正常汉族青少年PI显著低于同龄白种人(P〈0.05)。结论:正常汉族青少年骨盆参数PI、PT和SS在两性间不存在显著性差异。PI在青少年时期可随年龄的增长而增大,其中在10~13岁相对显著,而在14岁以后增长则基本趋于停止,推测骨盆在青少年时期的不同年龄段生长速率不同。
Objectives: To establish a reference of the sagittal pelvic parameters in normal adolescents of Chinese Han nationality, and to explore the risk factors and possible mechanism of sagittal pelvic imbalance. Methods: A prospective cohort of 171 asymptomatic adolescents of Chinese Han nationality(male∶ female=87∶84) aged 13.1±2.0y(10-17y) was recruited. For each subject, pelvic incidence(PI), pelvic tilt(PT) and sacral slope(SS) was measured respectively from the standing full-spine lateral radiographs. Ratios of SS to PI(SS/PI) and PT to PI(PT/PI) were also calculated. According to the age distribution, all subjects were divided into two groups: Group young(10-13y, 11.7±1.1y) and Group old(14-17y, 15.0±1.1y). Intra- and inter-group comparisons of the pelvic parameters were performed by means of independent-samples t test or rank sum test; and their correlations with age were also analyzed. Moreover, the comparison of PI between the previous literatures and this study was analyzed by using one-sample t test. Results: There was no significant difference in PI, SS and PT between males and females in the present study. PI and PT in Group young were significantly lower than Group old(P〈0.05); and SS remained unchanged with a slight downward trend(P〉0.05). The value was greater than 0.5 for SS/PI and less than 0.5 for PT/PI. The correlations between age and PI or PT were remarkable in all the adolescents with the age of 10-17yrs(r=0.243, r=0.371) and in Group young(r=0.229, r=0.231), but no correlation in Group old(P〉0.05); while there was no correlation between SS and age(P〉0.05). Furthermore, PI in adolescents of Chinese Han nationality was significantly lower than that in Caucasian teenagers(P〈0.05). Conclusions: There is no sex-related significant difference in PI, PT and SS. PI increases with age from 10 to 17 years old significantly, which presents more in adolescents of younger than 14 years, so it is considered that from 10