本文選題：雙能X線吸收法 + 骨強(qiáng)度�。� 參考：《暨南大學(xué)》2013年博士論文

【摘要】：目的通過(guò)雙能x線吸收法(DXA)重復(fù)測(cè)量的短期精密度試驗(yàn)來(lái)獲取股骨頸骨強(qiáng)度(HSA)參數(shù)與身體成分參數(shù)的精密度,并計(jì)算相應(yīng)誤差的最小顯著變化(LSC)。 方法73名健康成年志愿者進(jìn)行了雙側(cè)股骨近端的DXA HSA精密度試驗(yàn),分別計(jì)算單、雙側(cè)股骨近端骨密度(BMD)和HSA測(cè)量參數(shù)[截面面積(CSA)、截面轉(zhuǎn)動(dòng)慣量(CSMI)、截面模量(Z)、皮質(zhì)骨外徑(PD)、皮質(zhì)骨內(nèi)徑(ED)和皮質(zhì)骨厚度(CT)]的精密度[以變異系數(shù)均方根(RM-CV%表示)]；50名健康成年志愿者進(jìn)行了DXA全身掃描精密度試驗(yàn),計(jì)算全身身體成分DXA測(cè)量參數(shù)[脂肪含量(FM)、瘦組織含量(LM)和骨礦物質(zhì)含量(BMC)]的精密度(以RM-CV%表示)。并進(jìn)一步計(jì)算出在95%的可信區(qū)間內(nèi)所有測(cè)量參數(shù)誤差值的最小范圍(以LSC表示)。 結(jié)果DXA單側(cè)股骨頸測(cè)量中,HSA各參數(shù)RM-CV%在0.8～4.0%之間；雙側(cè)股骨頸測(cè)量中,HSA各參數(shù)的平均值RM-CV%在0.6～2.8%之間。雙側(cè)股骨頸測(cè)量HSA參數(shù)精密度較單側(cè)測(cè)量提高了13～33%。身體成分測(cè)量精密度各參數(shù)RMS-CV%均在2%以下。 結(jié)論采用DXA測(cè)量股骨頸HSA各參數(shù)和全身身體成分各參數(shù)的精密度較高,可以滿足臨床研究的需要。 目的在進(jìn)行了雙能X線吸收法(DXA)左、右側(cè)股骨頸骨強(qiáng)度(HSA)測(cè)量參數(shù)差異比較的基礎(chǔ)上,應(yīng)用HSA中的的骨強(qiáng)度參數(shù)和骨結(jié)構(gòu)參數(shù)分析股骨頸生物力學(xué)在不同性別、不同年齡階段以及不同骨折風(fēng)險(xiǎn)人群中的表現(xiàn)情況,探尋不同人群HSA參數(shù)隨年齡增長(zhǎng)而變化的結(jié)構(gòu)和力學(xué)生物學(xué)基礎(chǔ)。 方法400名不同人群受試者的左、右側(cè)股骨HSA測(cè)量參數(shù)分別采用配對(duì)t檢驗(yàn)和Pearson相關(guān)分析比較兩者之間的差異和相關(guān)性。分析了3855例男、女性人群代表股骨頸骨強(qiáng)度的HSA參數(shù)[截面面積(CSA)、截面轉(zhuǎn)動(dòng)慣量(CSMI)和截面模量(Z)]與年齡的相關(guān)性,比較人群不同階段之間(中青年男性和老年男性；絕經(jīng)前女性和絕經(jīng)后女性)HSA參數(shù)[CSA、CSMI、Z、皮質(zhì)骨外徑(PD)、皮質(zhì)骨內(nèi)徑(ED)和皮質(zhì)骨厚度(CT)]的差異。對(duì)正常組、骨量減少組和骨質(zhì)疏松組人群的HSA測(cè)量參數(shù)進(jìn)行多樣本比較的秩和檢驗(yàn),并應(yīng)用兩樣本比較的秩和檢驗(yàn)進(jìn)一步分析了絕經(jīng)后女性和老年男性人群HSA參數(shù)隨年齡變化的趨勢(shì)。 結(jié)果雙側(cè)股骨頸HSA各參數(shù)之間均沒(méi)有發(fā)現(xiàn)顯著差異(p0.05),且呈高度正相關(guān)(r=0.801～0.921,p0.05)。老年男性和絕經(jīng)后女性的CSA、CSMI和Z隨年齡增長(zhǎng)而顯著下降(r=-0.183～-0.495,p0.05),而中青年男性和絕經(jīng)后女性未發(fā)現(xiàn)與年齡增長(zhǎng)的負(fù)相關(guān)關(guān)系。絕經(jīng)后女性股骨頸骨CSA、CSMI和Z、CT低于絕經(jīng)前女性,PD和ED未發(fā)現(xiàn)兩組差異；老年男性股骨頸CSA、CSMI和Z和CT低于的中、青年男性,但PD和ED高于后者(p0.05)。老年男性和絕經(jīng)后女性的CSA、CSMI和Z均隨著骨折風(fēng)險(xiǎn)增加而降低,而且均隨著年齡增長(zhǎng)而降低,但是與股骨頸骨密度的下降趨勢(shì)并不一致(p0.05)。 結(jié)論左、右側(cè)股骨頸之間的骨強(qiáng)度沒(méi)有顯著差異。在股骨頸骨量隨著年齡的增加而減少的情況下,其強(qiáng)度也逐漸降低,但股骨頸通過(guò)骨的重建改變其截面的結(jié)構(gòu),存在對(duì)負(fù)荷減少以及對(duì)骨強(qiáng)度的維持的適應(yīng)現(xiàn)象。 目的本研究應(yīng)用雙能x線吸收法(DXA)分別在不同BMI階段的成年男、女人群中分析股骨頸骨強(qiáng)度(HSA)與不同身體成分之間的關(guān)系。 方法按世界衛(wèi)生組織(WHO)體重指數(shù)標(biāo)準(zhǔn)將受試者分組,低體重組(BMI≤18.5)女性329人,男性109人；正常體重組(18.5BMI25)女性1850人,男性718人；超重組(25≤BMI30)女性482人,男性282人；肥胖組(BMI≥30)女性52人,男性33人。分別測(cè)量每組人群的骨密度(BMD)、全身瘦組織(LM)含量、脂肪組織(FM)含量、以及HSA參數(shù)[截面面積(CSA)、截面轉(zhuǎn)動(dòng)慣量(CSMI)和截面模量(Z)],每組間進(jìn)行了HSA參數(shù)與身體成分參數(shù)的相關(guān)性分析和非配對(duì)t檢驗(yàn),并應(yīng)用協(xié)方差分析對(duì)HSA參數(shù)進(jìn)行了體重、FM和LM校正后的組間比較。 結(jié)果低體重組的CSMI、CSA和Z較正常體重組低,而超重和肥胖組CSMI、 CSA和Z高于正常體重組(p0.05)。在各組中LM均都與CSMI、CSA和Z呈高度正相關(guān)(r=0.310～0.616,p0.05)。當(dāng)經(jīng)過(guò)LM校正后,男、女性低體重、超重、肥胖組的CSA、CSMI和Z與正常體重組無(wú)顯著差異；當(dāng)經(jīng)過(guò)FM校正后,男、女性低體重、超重、肥胖組的CSMI、CSA和Z與正常體重組的統(tǒng)計(jì)學(xué)差異仍顯著存在(p0.05)；當(dāng)經(jīng)過(guò)體重校正后,男性低體重、超重、肥胖組的CSA、 CSMI和Z與正常體重組無(wú)顯著差異,女性低體重、超重、肥胖組的CSMI、CSA和Z與正常體重組的統(tǒng)計(jì)學(xué)差異仍顯著存在(p0.05)。多元回歸分析顯示：成年男、女性各組中中LM都是顯著變量,且LM的標(biāo)準(zhǔn)偏回歸系數(shù)均高于FM。 結(jié)論在成人男、女性人群中LM都是一個(gè)影響骨強(qiáng)度的決定因素,骨強(qiáng)度的高低主要是對(duì)LM所代表的動(dòng)態(tài)負(fù)荷適應(yīng)的結(jié)果。
[Abstract]:Objective to obtain the precision of the femoral neck bone strength (HSA) parameters and body component parameters by the short term precision test of double energy X-ray absorption (DXA) repeated measurement, and to calculate the minimum significant change of the corresponding error (LSC).
Methods 73 healthy adult volunteers were performed the DXA HSA precision test on the proximal femur of the femur. The accuracy of the single, bilateral femur proximal bone mineral density (BMD) and HSA parameters [cross section area (CSA), cross section inertia (CSMI), cross-section modulus (Z), cortical bone diameter (PD), cortical bone diameter (ED) and cortical bone thickness (CT)] were calculated. Number mean square root (RM-CV%)]; 50 healthy adult volunteers carried out a DXA whole body scan precision test to calculate the precision of the body composition DXA measurement parameters [fat content (FM), thin tissue content (LM) and bone mineral content (BMC)], and further calculated the error of all measurement parameters within the confidence interval of 95%. The minimum range of the value (as expressed in LSC).
Results in the measurement of DXA unilateral femoral neck, the parameters RM-CV% of HSA were between 0.8 and 4%. The average value of each parameter of HSA was from 0.6 to 2.8% in the bilateral femoral neck measurement. The precision of the HSA parameters of the bilateral femoral neck measurement was higher than that of the single side measurement, and the parameters RMS-CV% of the body composition of 13 to 33%. were less than 2%.
Conclusion using DXA to measure the parameters of femoral neck HSA and the parameters of whole body composition are more precise, which can meet the needs of clinical research.
Objective on the basis of the comparison of the differences in the measurement parameters of the left and right femoral neck bone strength (HSA) in the left and right femur (DXA), the performance of the biomechanics of the neck of the femur in different sex, different age stages and different bone fracture risk groups was analyzed by using the parameters of bone strength and bone structure in HSA, and the HSA parameters of different population were explored. The structural and biomechanics basis of number varies with age.
Methods the difference and correlation between the left and right femur HSA measurement parameters of 400 different subjects were compared with the paired t test and Pearson correlation analysis. The HSA parameters of the femoral neck bone strength (section area (CSA), cross section moment of inertia (CSMI) and section modulus (Z)) of the femur were analyzed in 3855 men and women. The difference between the HSA parameters [CSA, CSMI, Z, cortical bone diameter (PD), cortical bone diameter (ED) and cortical bone thickness (CT) between the different stages of the population (young and middle-aged men and elderly men; premenopausal women and postmenopausal women). The rank sum of the HSA measurement parameters in the normal group, the bone mass reduction group and the osteoporosis group was compared with the normal group. Test and apply the rank sum test of two samples to further analyze the trend of HSA parameters changing with age in postmenopausal women and elderly men.
Results there was no significant difference between the parameters of bilateral femoral neck HSA (P0.05), and there was a high positive correlation (r=0.801 to 0.921, P0.05). The CSA, CSMI and Z of the elderly and postmenopausal women were significantly decreased with age (r=-0.183 to -0.495, P0.05), while the negative correlation between young and postmenopausal women was not found in young and middle-aged men and postmenopausal women. Postmenopausal women with femoral neck bone CSA, CSMI and Z, and CT were lower than premenopausal women, PD and ED were not found in two groups; young men were lower than those of the femoral neck CSA, CSMI and Z and CT in the elderly male, but PD and ED were higher than those of the latter. The decrease was not consistent with the decreasing trend of femoral neck BMD (P0.05).
Conclusion there is no significant difference in bone strength between the left and the right femur neck. The strength of the femoral neck is gradually reduced with the increase of age, but the reconstruction of the femoral neck through the bone changes the structure of the cross section, and there is a reduction in the load and the adaptation to the maintenance of bone strength.
Objective to analyze the relationship between the bone strength of the femur (HSA) and the different body components in the adult male and female group at different BMI stages, respectively, by using the dual energy X-ray absorption (DXA) method.
Methods according to the WHO (WHO) body mass index standard, the subjects were divided into groups, 329 women with low body weight (BMI < 18.5), 109 men, 1850 women in normal weight group (18.5BMI25), 718 male, 482 women with 25 BMI30, 52 males and 33 men in obesity group (BMI > 30). The bone of each group was measured respectively. Density (BMD), body thin tissue (LM) content, adipose tissue (FM) content, HSA parameter [cross section area (CSA), cross section inertia (CSMI) and section modulus (Z)]. Each group carried out the correlation analysis of HSA parameters and body component parameters and unpaired t test, and used covariance analysis to carry on the weight, FM and LM correction group for HSA parameters. Compare with each other.
Results CSMI, CSA and Z were lower than normal weight groups, while CSMI, CSA and Z in overweight and obese groups were higher than normal weight group (P0.05). All LM in each group were highly correlated with CSMI, CSA and Z (r=0.310 ~ 0.616). After FM correction, there was a significant difference between male, female, low weight, overweight, obesity group, CSMI, CSA, and Z and normal weight group (P0.05). When body weight correction, male low weight, overweight, obesity group CSA, CSMI and Z and normal weight group have no significant difference, female low weight, overweight, obesity group CSMI, CSA and Z and positive. The statistical difference of the normal body recombination was still significant (P0.05). The multivariate regression analysis showed that the middle LM of the adult male and female groups were all significant variables, and the standard partial regression coefficients of LM were all higher than that of FM..
Conclusion in the adult male and female population, LM is a determinant of the bone strength, and the bone strength is the result of the adaptation to dynamic load represented by LM.
【學(xué)位授予單位】：暨南大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2013
【分類號(hào)】：R310

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