男女腰椎及髖部骨密度在原發(fā)性骨質(zhì)疏松癥診斷中的價(jià)值探討
發(fā)布時(shí)間：2018-11-21 10:16
【摘要】：背景及目的骨質(zhì)疏松癥(Osteoporosis,OP)是一種老年常見的疾病,是一種以骨量低下,骨微結(jié)構(gòu)破壞,導(dǎo)致骨脆性增加和骨強(qiáng)度下降,易發(fā)生骨折、骨性炎癥為特征的全身性骨病。而骨密度(bone mineral density,BMD)和骨質(zhì)量(bone mineral content,BMC)則是反映骨強(qiáng)度的兩個(gè)重要指標(biāo)。流行病學(xué)調(diào)查顯示,老年男女骨量減少患者隨著年齡的增長而增多,預(yù)示著將來會有更多老年人患病。而骨密度(BMD)的測定對于OP的診斷、預(yù)防、治療、并發(fā)骨折風(fēng)險(xiǎn)的評估有著重要的意義。本研究對比分析男女腰椎及髖部骨密度差異及相關(guān)性,并討論在原發(fā)性骨質(zhì)疏松診斷中的價(jià)值。研究方法選取2013年6月-2015年6月在浙江大學(xué)附屬邵逸夫醫(yī)院就診的老年患者,均為浙江地區(qū)居民共300例,分為男女兩組,其中男性103例,女性197例,分別統(tǒng)計(jì)病人基本信息,腰椎L1-L4及髖部各部位骨密度T值和發(fā)生骨質(zhì)疏松,骨密度異常的個(gè)數(shù),比較男女兩組各部位BMD指標(biāo)水平及相關(guān)性;比較OP及異常BMD的發(fā)生率;比較骨質(zhì)疏松患者發(fā)病部位的分布。研究結(jié)果1.女性組腰椎L1、L2、L3、L4、L1-4、股骨頸、Wards區(qū)、全髖骨的骨密度水平明顯低于男性組,差異有統(tǒng)計(jì)學(xué)意義(t分別=-9.42、-10.84、-10.66、…9.72、-11.05、-6.51、-8.95、-7.58,P 均0.001)。2.男女腰椎(L1-L4)椎體間BMD成正相關(guān)(r=0.684～0.927,p0.05);髖周骨BMD成正相關(guān)(r=0.825～0.848,p0.05);腰椎(L1-L4)與髖周骨BMD成正相關(guān)(r-0.339～0.666,p0.05)。3.男性O(shè)P檢出率髖部(20.4%)高于腰椎(12.6%),女性O(shè)P檢出率髖部(46.7%)低于腰椎(56.9%),差異無統(tǒng)計(jì)學(xué)意義(p0.05)。4.男女兩組腰椎+髖部聯(lián)合OP檢出率分別為23.3%和69.5%,腰椎和髖部聯(lián)合檢查可以提高OP、BMD異常檢出率(p0.05)。5.男女骨質(zhì)疏松發(fā)生部位分布百分比不同,男性組OP患者,僅腰椎發(fā)生OP占12.5%,僅髖部占45.8%,腰椎+髖部同時(shí)發(fā)生OP占41.7%;女性組OP患者僅腰椎發(fā)生OP占32.8%,僅髖部18.2%,腰椎+髖部同時(shí)發(fā)生OP占47.9%。兩組患者OP及BMD異常部位分布比較,差異存在統(tǒng)計(jì)學(xué)意義(p0.05)6.男性髖部BMD對OP診斷的敏感度較高,女性腰椎BMD對OP診斷的敏感度較高。研究結(jié)論:腰椎及髖部骨密度的測量對原發(fā)性骨質(zhì)疏松的臨床診斷至關(guān)重要,老年男性診斷原發(fā)性骨質(zhì)疏松癥可以首選測量髖部BMD,女性應(yīng)同時(shí)檢查腰椎與髖部BMD。如果條件允許,無論男女都應(yīng)該同時(shí)做腰椎及髖部骨密度檢查,提高診斷準(zhǔn)確率。
[Abstract]:Background and objective Osteoporosis (Osteoporosis,OP) is a common disease in the elderly. It is characterized by low bone mass, destruction of bone microstructure, increase of bone brittleness and decrease of bone strength, prone to fracture and osteoinflammation. Bone mineral density (bone mineral density,BMD) and bone mass (bone mineral content,BMC (BMD) are two important indicators of bone strength. Epidemiological studies show that the number of older men and women with reduced bone mass increases with age, indicating that more elderly people will become ill in the future. The determination of bone mineral density (BMD) is of great significance in the diagnosis, prevention, treatment and assessment of fracture risk of OP. In this study, the difference and correlation of bone mineral density in lumbar spine and hip between men and women were analyzed, and the value of bone mineral density in diagnosis of primary osteoporosis was discussed. Methods from June 2013 to June 2015, 300 elderly patients were selected from the run Shaw Hospital, Zhejiang University. They were divided into two groups: 103 males and 197 females. The T value of bone mineral density (BMD) and the number of osteoporosis and abnormal bone mineral density (BMD) in lumbar L1-L4 and hip were compared between male and female. To compare the incidence of OP and abnormal BMD, and to compare the location of osteoporosis. Results 1. The bone mineral density (BMD) of lumbar vertebrae L1, L2, L3, L4 and L1-4, femoral neck, Wards area, total hip bone in female group was significantly lower than that in male group (t = -9.42% -10.84% -10.66, respectively). 9.72U -11.05U -6.51U -8.95U -7.58 (P = 0.001). There was a positive correlation between BMD in lumbar vertebrae (r = 0.684 / 0.927 / p0.05) and BMD in perihip bone (r = 0.825 / 0. 848 / p0.05) in male and female lumbar vertebrae (L1-L4). There was a positive correlation between lumbar vertebrae (L1-L4) and perihip BMD (r-0. 339 / 0. 666p. 05). 3. The detection rate of OP in male hip (20.4%) was higher than that in lumbar vertebrae (12.6%). The detection rate of female OP in hip (46.7%) was lower than that in lumbar vertebra (56.9%). There was no significant difference (p0.05). The detection rate of combined OP in lumbar spine and hip was 23. 3% and 69. 5%, respectively. The combined examination of lumbar spine and hip could increase the detection rate of OP,BMD abnormality (p 0. 05). In male group, only OP occurred in lumbar spine, 45.8% in hip and 41.7% in lumbar hip in male patients with OP. In female patients with OP, only OP occurred in the lumbar vertebrae (32. 8%), only in the hip (18. 2) and in the lumbar hip (47. 9%). There was a significant difference in the distribution of abnormal OP and BMD between the two groups (p0. 05). The sensitivity of male hip BMD to OP was higher than that of female lumbar BMD to OP. Conclusion: the measurement of bone mineral density of lumbar vertebrae and hip is very important for the clinical diagnosis of primary osteoporosis. Elderly men can choose to measure BMD, of hip at the same time. BMD. of lumbar vertebra and hip should be examined. If conditions permit, both men and women should do lumbar and hip bone mineral density examination to improve diagnostic accuracy.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R580
，
本文編號：2346681
[Abstract]:Background and objective Osteoporosis (Osteoporosis,OP) is a common disease in the elderly. It is characterized by low bone mass, destruction of bone microstructure, increase of bone brittleness and decrease of bone strength, prone to fracture and osteoinflammation. Bone mineral density (bone mineral density,BMD) and bone mass (bone mineral content,BMC (BMD) are two important indicators of bone strength. Epidemiological studies show that the number of older men and women with reduced bone mass increases with age, indicating that more elderly people will become ill in the future. The determination of bone mineral density (BMD) is of great significance in the diagnosis, prevention, treatment and assessment of fracture risk of OP. In this study, the difference and correlation of bone mineral density in lumbar spine and hip between men and women were analyzed, and the value of bone mineral density in diagnosis of primary osteoporosis was discussed. Methods from June 2013 to June 2015, 300 elderly patients were selected from the run Shaw Hospital, Zhejiang University. They were divided into two groups: 103 males and 197 females. The T value of bone mineral density (BMD) and the number of osteoporosis and abnormal bone mineral density (BMD) in lumbar L1-L4 and hip were compared between male and female. To compare the incidence of OP and abnormal BMD, and to compare the location of osteoporosis. Results 1. The bone mineral density (BMD) of lumbar vertebrae L1, L2, L3, L4 and L1-4, femoral neck, Wards area, total hip bone in female group was significantly lower than that in male group (t = -9.42% -10.84% -10.66, respectively). 9.72U -11.05U -6.51U -8.95U -7.58 (P = 0.001). There was a positive correlation between BMD in lumbar vertebrae (r = 0.684 / 0.927 / p0.05) and BMD in perihip bone (r = 0.825 / 0. 848 / p0.05) in male and female lumbar vertebrae (L1-L4). There was a positive correlation between lumbar vertebrae (L1-L4) and perihip BMD (r-0. 339 / 0. 666p. 05). 3. The detection rate of OP in male hip (20.4%) was higher than that in lumbar vertebrae (12.6%). The detection rate of female OP in hip (46.7%) was lower than that in lumbar vertebra (56.9%). There was no significant difference (p0.05). The detection rate of combined OP in lumbar spine and hip was 23. 3% and 69. 5%, respectively. The combined examination of lumbar spine and hip could increase the detection rate of OP,BMD abnormality (p 0. 05). In male group, only OP occurred in lumbar spine, 45.8% in hip and 41.7% in lumbar hip in male patients with OP. In female patients with OP, only OP occurred in the lumbar vertebrae (32. 8%), only in the hip (18. 2) and in the lumbar hip (47. 9%). There was a significant difference in the distribution of abnormal OP and BMD between the two groups (p0. 05). The sensitivity of male hip BMD to OP was higher than that of female lumbar BMD to OP. Conclusion: the measurement of bone mineral density of lumbar vertebrae and hip is very important for the clinical diagnosis of primary osteoporosis. Elderly men can choose to measure BMD, of hip at the same time. BMD. of lumbar vertebra and hip should be examined. If conditions permit, both men and women should do lumbar and hip bone mineral density examination to improve diagnostic accuracy.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R580
，
本文編號：2346681
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