慢性病防治专栏

联合髋臼深度角与Sharp角对成人髋臼发育不良的诊断价值

  • 詹金典 ,
  • 吴云龙 ,
  • 凡一诺 ,
  • 陈志文 ,
  • 高张 ,
  • 陈犇璐 ,
  • 卢鸿铎 ,
  • 胡云浩 ,
  • 程畅波 ,
  • 方汉军 ,
  • 黄泽青 ,
  • 周驰 ,
  • 陈镇秋
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  • 1.广州中医药大学第一临床医学院 (广东 广州 510405 )
    2.广东省中医临床研究院 (广东 广州 510405 )
    3.广州中医药大学第一附属医院股骨头坏死科 (广东 广州 510405 )
    4.中山市民众医院中医康复科 (广东 中山 528400 )

收稿日期: 2025-08-24

  网络出版日期: 2026-03-09

基金资助

国家自然科学基金项目(82374475);中医证候全国重点实验室(SKLKY2024B0004Z);广州市临床高新、重大、特色技术建设项目(2023P-TS22)

Acetabular depth angle and sharp angle were used to diagnose adult acetabular dysplasia

  • Jindian ZHAN ,
  • Yunlong WU ,
  • Yinuo FAN ,
  • Zhiwen CHEN ,
  • Zhang GAO ,
  • Benlu CHEN ,
  • Hongduo LU ,
  • Yunhao HU ,
  • Changbo CHENG ,
  • Hanjun FANG ,
  • Zeqing HUANG ,
  • Chi ZHOU ,
  • Zhenqiu CHEN
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  • 1.The First Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China
    2.Guangdong Provincial Institute of Clinical Chinese Medicine,Guangzhou 510405,Guangdong,China
    3.Department of Femoral Head Necrosis,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China
    4.Department of Traditional Chinese Medicine Rehabilitation,Zhongshan Minzhong Hospital,Zhongshan 528400,Guangdong,China

Received date: 2025-08-24

  Online published: 2026-03-09

摘要

目的 在中心边缘角无法测量时,探索成人髋臼发育不良的有效辅助诊断指标,并建立基于影像学参数的组合评价方法,为髋关节疾病的诊断及评估提供新思路。 方法 采用回顾性病例对照研究,纳入成人髋臼发育不良患者成人髋臼发育不良组(59例,101髋)及髋臼正常者髋臼正常组(33例,66髋)。收集基线资料,测量两组CE角、髋臼深度角、Sharp角、臼顶倾斜角、股骨颈干角。通过二元logistic回归筛选独立预测因子并构建联合诊断模型,利用ROC曲线确定最佳截断值,最终开发桌面应用软件实现模型临床转化。 结果 成人髋臼发育不良组髋臼深度角、Sharp角、臼顶倾斜角、股骨颈干角与髋臼正常组差异有统计学意义(P < 0.05)。logistic回归显示髋臼深度角(OR = 0.297, 95%CI: 0.152 ~ 0.579)是髋臼发育不良的保护因素,Sharp角(OR = 2.964, 95%CI:1.577 ~ 5.572)是髋臼发育不良的独立危险因素。联合模型AUC达0.995(95%CI:0.989 ~ 1.000),显著优于单一指标(P < 0.05)。ROC最佳截断值为0.760(灵敏度98.1%,特异度95.5%)。 结论 基于髋臼深度角与Sharp角的联合诊断模型能有效识别成人髋臼发育不良病例,其高诊断效能具有一定的临床价值,配套软件可提升实用性。

本文引用格式

詹金典 , 吴云龙 , 凡一诺 , 陈志文 , 高张 , 陈犇璐 , 卢鸿铎 , 胡云浩 , 程畅波 , 方汉军 , 黄泽青 , 周驰 , 陈镇秋 . 联合髋臼深度角与Sharp角对成人髋臼发育不良的诊断价值[J]. 实用医学杂志, 2026 , 42(5) : 777 -784 . DOI: 10.3969/j.issn.1006-5725.2026.05.007

Abstract

Objective To identify alternative diagnostic indicators for adult developmental dysplasia of the hip (DDH) and establish a radiographically?based combinatorial evaluation method when the center?edge (CE) angle is unmeasurable. Methods This retrospective case?control study included 59 DDH patients (101 hips) and 33 controls (66 hips). Radiographic parameters?the CE angle, acetabular roof angle (ACM angle), Sharp angle, acetabular roof obliquity (ARO), and neck?shaft angle (NSA)?were measured. Binary logistic regression identified independent predictors, and receiver operating characteristic (ROC) analysis determined optimal thresholds. A diagnostic model was implemented as a desktop application. Results Developmental dysplasia of the hip exhibited significant differences in acetabular roof obliquity, ACM angle, Sharp angle, and NSA (P < 0.05). The ACM angle (OR = 0.297, 95% CI: 0.152 - 0.579) and Sharp angle (OR = 2.964, 95% CI: 1.577 - 5.572) were identified as independent predictors. The combined model achieved an area under the curve (AUC) of 0.995 (95% CI: 0.989 - 1.000), surpassing individual parameters (P < 0.05), with a cutoff value of 0.760 (98.1% sensitivity, 95.5% specificity). Conclusion The ACM?Sharp angle model effectively diagnoses developmental dysplasia of the hip with high clinical utility. Integrated software facilitates implementation.

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