目的:探讨Cheneau支具佩戴依从性与高侧凸进展风险青少年特发性脊柱侧凸(adolescent idiopathic scoliosis,AIS)患者侧凸进展的关系,比较不同依从性患者的健康相关生存质量。方法:2007年1月~2012年12月,在我院行Cheneau支具治疗的高侧凸进展风险AIS患者73例,初诊时平均年龄为12.8±1.2岁,平均主弯Cobb角31.4°±6.0°,平均Risser征为0.7±0.8级。所有患者每3~6个月定期复查,行临床及影像学检查,摄站立位脊柱全长正侧位X线片。在末次随访时每位患者填写健康相关生存质量问卷量表。侧凸进展定义为末次随访Cobb角大于初诊6°以上或治疗期间建议行矫形手术(Cobb角>45°),其余为非进展。依从定义为患者每天坚持佩戴支具时间≥22h直至随访终止,否则视为不依从。随访结束后根据患者依从性不同将患者分为2组,应用独立样本t检验和卡方检验分析依从性对患者侧凸进展及健康相关生存质量的影响。结果:平均随访时间为1.8±0.8年。根据依从性定义,47例(64%)患者被纳入依从组,26例(36%)纳入不依从组。依从组患者末次随访时主弯Cobb角(28.9°±11.7°)明显小于不依从组(38.6°±11.6°),有统计学差异(P<0.01)。依从组侧凸进展率明显低于不依从组(OR 5.7,95%CI 1.9~16.8,P<0.01)。末次随访时不依从组自我形象/外观、精神健康、治疗满意度三个维度的得分均低于依从组(P<0.01);不依从组患者欧洲五维健康量表得分亦明显低于依从组(P<0.01)。结论:良好的支具佩戴依从性可降低高侧凸进展风险AIS患者的侧凸进展率,提高患者健康相关生存质量。 OBJECTIVE: To investigate the relationship between Cheneau brace compliance and scoliosis progression in patients with adolescent idiopathic scoliosis (AIS) at high risk of developing adolescent scoliosis (AIS), and to compare the health-related quality of life among different compliance patients. METHODS: From January 2007 to December 2012, 73 patients with high-risk progression-risk AIS were treated with Cheneau brace in our hospital. The mean age at first visit was 12.8 ± 1.2 years. The mean Cobb angle was 31.4 ° ± 6.0 °, the average Risser sign is 0.7 ± 0.8 grade. All patients were reviewed regularly every 3 to 6 months for clinical and radiographic examinations. At the last visit, each patient completed a health-related quality of life questionnaire. The progression of scoliosis was defined as the Cobb angle at the last follow-up was greater than 6 ° at the first visit or orthopedic surgery (Cobb angle> 45 °) was recommended during treatment and the rest was non-progression. Compliance defined as patients adhere to the daily wear brace ≥ 22h until the termination of follow-up, otherwise regarded as non-compliance. After follow-up, patients were divided into two groups according to different patient compliance. The independent samples t-test and chi-square test were used to analyze the influence of compliance on the progress of scoliosis and the quality of life-related quality of life. Results: The average follow-up time was 1.8 ± 0.8 years. According to the definition of compliance, 47 (64%) patients were included in the compliance group and 26 patients (36%) were included in the non-compliance group. The Cobb angle (28.9 ° ± 11.7 °) at the final follow-up in the follow-up group was significantly lower than that in the non-compliance group (38.6 ° ± 11.6 °) (P <0.01). The progression rate of the compliance group was significantly lower than that of the non-compliance group (OR 5.7, 95% CI 1.9-16.8, P <0.01). At the last follow-up, the score of self-image / appearance, mental health and satisfaction of patients in non-compliance group was lower than that of compliance group (P <0.01). The score of European five-dimensional health scale in non-compliance group was significantly lower than that of compliance group (P <0.01). CONCLUSIONS: Good braid compliance can reduce the progression rate of scoliosis in patients with advanced scoliosis and improve the health-related quality of life of patients.