小脑扁桃体下疝畸形患者营养障碍相关因素分析

目的：探讨小脑扁桃体下疝畸形患者营养障碍的情况。方法选取经头颈部 MRI 确诊为小脑扁桃体下疝畸形，伴或不伴脊髓空洞症状且排除颅底凹陷症的患者93例(观察组)，其中伴发脊髓空洞的小脑扁桃体下疝畸形患者62例(伴脊髓空洞组)，单纯小脑扁桃体下疝畸形患者31例(单纯组)；选取年龄和性别匹配的健康体检者100例(对照组)，分别记录观察组和对照组的年龄、身高、体质量、上臂围、腰围、臀围、血红蛋白，并进行比较，再将两组按照性别分组后分别比较营养状况差异。最后将伴脊髓空洞组和单纯组进行营养状况比较。结果观察组患者在体质指数(BMI)、上臂围、腰围、臀围、血红蛋白水平方面明显小于对照组，差异有统计学意义(P <0.05)。单纯组与伴脊髓空洞组的 BMI、上臂围、腰围、臀围、血红蛋白水平相比，差异有统计学意义(P <0.05))。男性小脑扁桃体下疝畸形患者中 BMI、上臂围、腰围、臀围均小于同组女性，差异有统计学意义(P <0.05)，且男、女性小脑扁桃体下疝畸形患者各种指标均小于相同性别、年龄的健康对照组，差异有统计学意义(P <0.05)。结论小脑扁桃体下疝畸形患者存在明显营养障碍，并且营养障碍在不同性别和是否伴有脊髓空洞上有差异。改善患者营养障碍有可能促进小脑扁桃体下疝畸形的恢复。

Factors of Dystrophia in Patients with Chiari Malformations Type I

Objective To discuss the situation of dystrophia in patients with Chiari Malformation Type I. Methods A total of 93 patients diagnosed with Chiari Malformation Type I(observational group)with or without syringomyelia and without basilar invagination by a combined head and cervical spine MRI were selected,and divided into syringomyelia group(with syringomyelia,n=62)and single group(without syringomyelia,n=31);100 healthy people with same age and gender were selected as control group and the age,height,weight,biceps circumference, waist circumference,hip circumference and hemoglobin of observational group and control group were recorded and compared respectively,and the nutritional status were compared after grouped by gender,and finally a comparison between syringomyelia group and single group was conducted.Results The BMI,biceps circumference,waist circumference,hip circumference,hemoglobin of patients in observational group were markedly lower than those of control group,the difference of which was statistically significant(P <0.05).And significant differences in BMI, biceps circumference,waist circumference,hip circumference,hemoglobin were found between single group and syringomyelia group(P < 0.05 ).The BMI,biceps circumference,waist circumference,hip circumference in male CMI patients were lower than those in female CMI patients(P < 0.05 ).And all of the indexes of both male and female CMI patients were lower than those of the healthy patients of the same age and gender(P <0.05).Conclusion Dystrophia is apparent in CMI patients and there are differences among patients of different genders and patients with or without syringomyelia.The improvement in dystrophia may benefit the recovery of CMI.