發(fā)布時間：2018-02-02 03:06

  本文關鍵詞： 2型糖尿病 骨質疏松癥 骨密度　出處：《石河子大學》2015年碩士論文　論文類型：學位論文

【摘要】：目的:1.了解2型糖尿病患者骨質疏松癥的發(fā)生情況并分析可能的影響因素。2.探討跟骨定量超聲法在骨質疏松癥診斷中的臨床應用價值。方法:收集2013年12月到2014年5月在石河子大學醫(yī)學院第一附屬醫(yī)院內(nèi)分泌科住院的2型糖尿病患者的一般資料、生化指標及并發(fā)癥發(fā)生情況,以雙能X線骨密度儀檢測結果為診斷金標準,將2型糖尿病患者分為骨質疏松癥組、非骨質疏松癥組,運用卡方檢驗進行危險因素單變量分析,二分類變量的Logistic回歸進行多變量分析,觀察2型糖尿病患者骨質疏松癥的發(fā)生情況并分析可能的影響因素,同時應用定量超聲骨密度檢測儀檢測患者跟骨的骨強度,繪制受試者工作特征曲線,探討跟骨定量超聲法在骨質疏松癥診斷中的臨床應用價值。結果:單變量相關分析顯示:病程(OR=2.684)、周圍神經(jīng)病變(OR=4.440)、高血壓(OR=2.281)、冠心病(OR=2.622)與2型糖尿病性骨質疏松呈顯著的正相關(P0.05),體重指數(shù)(OR=0.279)、高密度脂蛋白(OR=0.320)與2型糖尿病性骨質疏松呈顯著負相關(P0.05);多變量相關分析顯示BMI(OR=0.311)與2型糖尿病性骨質疏松呈顯著的負相關(P0.05),周圍神經(jīng)病變(OR=3.795)與骨質疏松呈顯著正相關(P0.05);跟骨定量超聲檢測法與雙能X線檢測法診斷男性、女性T2DM患者骨質疏松癥的靈敏度分別為44.44%、34.99%,特異度分別為97.22%、99.17%,定量超聲檢測當T=-1.950時,受試者工作特征曲線下面積(0.807)最大時,靈敏度為57.7%,特異度為89.3%。結論:1.2型糖尿病性骨質疏松癥與多種因素有關,其中病程、周圍神經(jīng)病變、高血壓、冠心病是其危險因素,體重指數(shù)、高密度脂蛋白是其保護因素。2.定量超聲檢測與雙能X線檢測相比,在臨床中有一定的診斷價值。
[Abstract]:Objective 1. To understand the occurrence of osteoporosis in type 2 diabetes mellitus and analyze the possible influencing factors. 2. To explore the clinical value of calcaneal quantitative ultrasound in the diagnosis of osteoporosis. Methods:. General data of type 2 diabetic patients hospitalized in Endocrinology Department of the first affiliated Hospital of Shihezi University Medical College from December 2013 to May 2014 were collected. According to the results of dual-energy X-ray absorptiometry, the patients with type 2 diabetes were divided into osteoporosis group and non-osteoporosis group. The single variable analysis of risk factors was carried out by chi-square test, and the multivariate analysis was carried out by Logistic regression of two classified variables. Objective: to observe the occurrence of osteoporosis in type 2 diabetes mellitus and analyze the possible influencing factors. At the same time, the bone strength of calcaneus was measured by quantitative ultrasound bone density detector, and the operating characteristic curve was drawn. Objective: to evaluate the clinical value of calcaneal quantitative ultrasound in the diagnosis of osteoporosis. Results: univariate correlation analysis showed that the course of disease was 2.684, and peripheral neuropathy was 4.440). There was a significant positive correlation between hypertension and type 2 diabetes mellitus osteoporosis (P 0.05, BMI = 0.279). High density lipoprotein (HDL) 0.320) was negatively correlated with type 2 diabetic osteoporosis (P 0.05). Multivariate correlation analysis showed that there was a significant negative correlation between BMIO 0.311) and type 2 diabetic osteoporosis (P 0.05). There was a significant positive correlation between peripheral neuropathy and osteoporosis (P 0.05). The sensitivity and specificity of calcaneal quantitative ultrasound and dual-energy X-ray in diagnosis of osteoporosis in female patients with T2DM were 44.44 ~ 34.99 and 97.22% respectively. 99. The sensitivity of quantitative ultrasound was 57.7% when the area under the operating characteristic curve was 0.807. Conclusion Osteoporosis caused by type 1.2 diabetes is related to many factors, including course of disease, peripheral neuropathy, hypertension, coronary heart disease, and body mass index. High density lipoprotein (HDL) is the protective factor. Compared with dual energy X ray detection, quantitative ultrasound has certain diagnostic value in clinic.
【學位授予單位】：石河子大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R587.1;R580

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