本文關(guān)鍵詞： OSTA 老年人群 骨質(zhì)疏松 AOC曲線 AUC　出處：《浙江大學(xué)》2015年博士論文　論文類型：學(xué)位論文

【摘要】：目的 本研究針對杭州地區(qū)老年人群,以DXA測定骨密度為骨質(zhì)疏松診斷標(biāo)準(zhǔn),評價OSTA對骨質(zhì)疏松的診斷價值,為其推廣運(yùn)用提供依據(jù)。 方法 本研究選取2010-2014年在浙江大學(xué)附屬邵逸夫醫(yī)院進(jìn)行骨密度檢查的大于60歲的人群,共計11540例,其中男性3087例,女性8453例。骨密度檢查由專業(yè)人士操作,使用GE LUNAR公司生產(chǎn)的prodigy advance雙能X線骨密度儀(dual energy x-ray absorptiometry, DXA)測量腰椎(L1-L4)骨密度。按照WHO1994年的骨質(zhì)疏松診斷標(biāo)準(zhǔn)將人群分成3組,骨量正常組：骨密度在健康同性別成人均值-1SD以上(T-1)；低骨量組：骨密度在健康同性別成人均值-1--2.5SD(-1≥T-2.5)；骨質(zhì)疏松組：骨密度在健康同性別成人均值-2.5SD以下(T≤-2.5)。并按照不同骨量(骨質(zhì)疏松,骨量減少,骨量正常),不同年齡(60-70歲,70-80歲,80歲),不同OSTA指數(shù)(-4,-1--4,-1)將人群進(jìn)行分類,分別統(tǒng)計OSTA指數(shù),年齡,身高,體重,BMI,腰椎骨密度,T值等基本信息,并計算不同年齡段的受試者工作特征曲線(Receiver Operating Characteristic, ROC)曲線下面積(area under curve, AUC)以及敏感度和特異度。結(jié)果使用Statistical Product and Service Solutions(SPSS)16.0進(jìn)行數(shù)據(jù)的整理和分析,兩組間均值比較采用T檢驗,多組比較采用單因素方差分析(Analysis of Variance, ANOVA),并采用Bonferroni進(jìn)行校正檢驗。相關(guān)系數(shù)采用pearson相關(guān)性分析。 結(jié)果 1、男性人群的腰椎BMD, OSTA指數(shù)明顯大于女性,骨質(zhì)疏松癥及骨量減少人群的比例也明顯低于女性(4.2%vs35.0%,18.8%vs41.4%)。 2、腰椎骨密度與女性年齡負(fù)相關(guān)(1=-0.189),與男性體重,身高,BMI, OSTA指數(shù)正相關(guān)(r=0.360,0.191,0.328,0.252),與女性體重,身高,BMI, OSTA指數(shù)正相關(guān)(r=0.456,0.300,0.365,0.439)。 3、取截斷值為-1時,OSTA指數(shù)篩查男性骨質(zhì)疏松的敏感性和特異性分別80.8%和55.7%,ROC曲線下面積為0.759。OSTA指數(shù)篩查女性骨質(zhì)疏松的敏感性和特異性分別為88.4%和34.4%,ROC曲線下面積為0.722。 結(jié)論 OSTA指數(shù)能較有效的篩查杭州地區(qū)老年人中的骨質(zhì)疏松高危人群。
[Abstract]:Purpose The purpose of this study was to evaluate the diagnostic value of DXA in the diagnosis of osteoporosis by using DXA as the diagnostic criterion for osteoporosis, and to provide a basis for its popularization and application. Method In this study, a total of 11540 patients aged over 60 years were selected for bone mineral density examination in the run run run Shaw Hospital affiliated to Zhejiang University from 2010 to 2014, including 3 087 males. Bone mineral density examination was performed by professionals. Prodigy advance dual energy X-ray absorptiometry made by GE LUNAR. Dual energy x-ray absorptiometry. Bone mineral density (BMD) of lumbar spine L1-L4 was measured by DXA. The patients were divided into 3 groups according to the criteria for diagnosis of osteoporosis in WHO1994 years. Normal bone mass group: BMD was higher than -1 SD in healthy adults of the same sex. In the low bone mass group, the mean value of BMD in healthy adults of the same sex was -1-2.5SDN -1 鈮，

本文編號：1480413