本文關(guān)鍵詞： 2型糖尿病 骨質(zhì)疏松癥 骨密度　出處：《石河子大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:1.了解2型糖尿病患者骨質(zhì)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(zhì)疏松癥診斷中的臨床應(yīng)用價(jià)值。方法:收集2013年12月到2014年5月在石河子大學(xué)醫(yī)學(xué)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(biāo)及并發(fā)癥發(fā)生情況,以雙能X線骨密度儀檢測(cè)結(jié)果為診斷金標(biāo)準(zhǔn),將2型糖尿病患者分為骨質(zhì)疏松癥組、非骨質(zhì)疏松癥組,運(yùn)用卡方檢驗(yàn)進(jìn)行危險(xiǎn)因素單變量分析,二分類變量的Logistic回歸進(jìn)行多變量分析,觀察2型糖尿病患者骨質(zhì)疏松癥的發(fā)生情況并分析可能的影響因素,同時(shí)應(yīng)用定量超聲骨密度檢測(cè)儀檢測(cè)患者跟骨的骨強(qiáng)度,繪制受試者工作特征曲線,探討跟骨定量超聲法在骨質(zhì)疏松癥診斷中的臨床應(yīng)用價(jià)值。結(jié)果:單變量相關(guān)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(zhì)疏松呈顯著的正相關(guān)(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(zhì)疏松呈顯著負(fù)相關(guān)(P0.05);多變量相關(guān)分析顯示BMI(OR=0.311)與2型糖尿病性骨質(zhì)疏松呈顯著的負(fù)相關(guān)(P0.05),周圍神經(jīng)病變(OR=3.795)與骨質(zhì)疏松呈顯著正相關(guān)(P0.05);跟骨定量超聲檢測(cè)法與雙能X線檢測(cè)法診斷男性、女性T2DM患者骨質(zhì)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(cè)當(dāng)T=-1.950時(shí),受試者工作特征曲線下面積(0.807)最大時(shí),靈敏度為57.7%,特異度為89.3%。結(jié)論:1.2型糖尿病性骨質(zhì)疏松癥與多種因素有關(guān),其中病程、周圍神經(jīng)病變、高血壓、冠心病是其危險(xiǎn)因素,體重指數(shù)、高密度脂蛋白是其保護(hù)因素。2.定量超聲檢測(cè)與雙能X線檢測(cè)相比,在臨床中有一定的診斷價(jià)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(xué)位授予單位】：石河子大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R587.1;R580

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