本文選題：骨質(zhì)疏松 + 脆性骨折��； 參考：《中國醫(yī)學(xué)物理學(xué)雜志》2017年05期

【摘要】：目的:探討絕經(jīng)后女性髖部結(jié)構(gòu)幾何力學(xué)參數(shù)在預(yù)測髖部脆性骨折危險性的臨床意義。方法:選取216例絕經(jīng)后女性,其中髖部骨折70例,正常對照組146例,測量股骨頸骨密度(FN-BMD),并用髖結(jié)構(gòu)分析(HSA)軟件在DXA掃描圖像上分析得出髖結(jié)構(gòu)幾何力學(xué)參數(shù),包括截面彎曲模量(SEM)、股骨頸橫截面轉(zhuǎn)動慣量(CSMI)、股骨頸橫截面積(CSA)、屈曲應(yīng)力比(BR)、股骨頸的皮質(zhì)骨厚度(FNCT)及股骨頸干角(NSA)。利用ROC曲線分別分析其預(yù)測髖部骨折的效能。結(jié)果:FN-BMD、CSA、CSMI、FNCT、SEM在骨折組低于對照組(P0.05),年齡、BR在骨折組高于對照組(P0.05)。Logistic回歸分析。年齡、BMI、FN-BMD、CSA、CSMI、FNCT、SEM、BR影響骨折發(fā)生的因素,得出FN-BMD、FNCT是判定絕經(jīng)后婦女髖部脆性骨折最相關(guān)的危險因素。FN-BMD、CSA、CSMI、FNCT、SEM與年齡呈負相關(guān),CSA、SEM與FN-BMD呈顯著正相關(guān)(r分別為0.945、0.763,P0.001),BR與FN-BMD呈顯著負相關(guān)(r=-0.854,P0.001),與年齡呈中度正相關(guān)。NSA角與年齡、絕經(jīng)年齡、FN-BMD無相關(guān)性。通過ROC曲線分析髖關(guān)節(jié)幾何學(xué)參數(shù)、FN-BMD及二者聯(lián)合預(yù)測髖部骨折準確度,發(fā)現(xiàn)髖關(guān)節(jié)幾何學(xué)參數(shù)聯(lián)合FN-BMD的ROC曲線下面積為0.860(P=0.000),高于FN-BMD及髖關(guān)節(jié)幾何學(xué)參數(shù)單獨對脆性骨折的預(yù)測,并且曲線下面積差異存在統(tǒng)計學(xué)意義(P0.05)。結(jié)論:(1)絕經(jīng)后婦女的髖部骨強度不僅與骨量丟失相關(guān),還與幾何力學(xué)空間因素改變相關(guān),故臨床預(yù)測髖部脆性骨折應(yīng)考慮FN-BMD及髖幾何結(jié)構(gòu)參數(shù);(2)髖結(jié)構(gòu)分析聯(lián)合FN-BMD測定可以提高髖部脆性骨折風(fēng)險的預(yù)測水平。
[Abstract]:Objective: to investigate the clinical significance of postmenopausal hip structure geometric mechanical parameters in predicting the risk of fragile hip fracture.Methods: a total of 216 postmenopausal women, including 70 hip fractures and 146 normal controls, were selected to measure the bone mineral density of femoral neck (FN-BMDN) and to obtain the geometrical mechanical parameters of hip structure on DXA scanning images.These include the bending modulus of the femoral neck, the moment of inertia of the cross section of the femoral neck, the cross sectional area of the femoral neck, the flexion stress ratio (BRN), the cortical bone thickness of the femoral neck, and the angle of the femoral neck.The effectiveness of ROC curve in predicting hip fracture was analyzed.Results the percentage of FNCTSEM in the fracture group was lower than that in the control group (P 0.05), and the age of Br in the fracture group was higher than that in the control group (P 0.05).Age of BMIA FN-BMDA CSAC CSMIA FNCTA SEMBR influence factors of fracture,There was no correlation between FN-BMD and menopausal age.The accuracy of hip fracture prediction was analyzed by ROC curve and the combination of FN-BMD and FN-BMD. It was found that the area under the ROC curve of hip geometry parameter combined with FN-BMD was 0.860 P0. 000, which was higher than that of FN-BMD and hip geometry parameters alone in predicting brittle fracture.The difference of area under the curve was statistically significant (P 0.05).Conclusion the hip bone strength of postmenopausal women is related not only to bone loss, but also to the spatial change of geometric mechanics.Therefore, the clinical prediction of fragile hip fracture should consider FN-BMD and hip geometric structure parameters. The hip structure analysis combined with FN-BMD measurement can improve the prediction level of the risk of fragile hip fracture.
【作者單位】： 福建醫(yī)科大學(xué)附屬第二醫(yī)院;泉州醫(yī)學(xué)高等�？茖W(xué)校;
【基金】：泉州市科技局社會發(fā)展計劃重點資助項目(2013Z106)
【分類號】：R580;R683

【相似文獻】

相關(guān)期刊論文 前9條

1 王萍萍;柯耀華;張浩;胡偉偉;胡云秋;李淼;傅文貞;劉玉娟;章振林;;絕經(jīng)后婦女740例脆性骨折部位與骨密度關(guān)系的分析[J];中國全科醫(yī)學(xué);2010年04期

2 樓慧玲;彭程;陳巧聰;;三種骨代謝標志物的測定在老年骨質(zhì)疏松癥患者髖部脆性骨折中的臨床價值[J];南方醫(yī)科大學(xué)學(xué)報;2012年09期

3 國宇;;從脆性骨折患者的骨密度結(jié)果看骨質(zhì)疏松癥的早期診斷分析[J];大家健康(學(xué)術(shù)版);2013年15期

4 楊繼良;許筠;王經(jīng)韜;;老年骨質(zhì)疏松癥與脆性骨折防治方法探析[J];甘肅科技縱橫;2009年05期

5 黃鎮(zhèn)河;毛艷芳;吳紅玲;黎麗萍;崔艷鳳;閻德文;;從脆性骨折患者的骨密度結(jié)果看骨質(zhì)疏松癥的早期診斷[J];廣東醫(yī)學(xué);2011年14期

6 徐錚;孫君雷;許忠;顧昊;夏芳;李冠武;常時新;周蕾;;DXA髖結(jié)構(gòu)分析參數(shù)預(yù)測髖部脆性骨折的價值[J];中國骨質(zhì)疏松雜志;2014年04期

7 ;HIV患者的低骨密度、脆性骨折風(fēng)險增加[J];基礎(chǔ)醫(yī)學(xué)與臨床;2011年08期

8 徐琳;金暉;孫子林;;糖尿病與脆性骨折[J];中國骨質(zhì)疏松雜志;2009年05期

9 ;[J];;年期

相關(guān)會議論文 前2條

1 汪純;何進衛(wèi);章振林;;SOSTDC1基因多態(tài)性與絕經(jīng)后婦女脆性骨折相關(guān)性研究[A];2009中華醫(yī)學(xué)會骨質(zhì)疏松癥中青年學(xué)者論壇論文集[C];2009年

2 張偉;徐又佳;;絕經(jīng)后女性髖部脆性骨折松質(zhì)骨鈣、鎂、鐵、銅、錳、鋅與骨密度關(guān)系的初步報告[A];中華醫(yī)學(xué)會第七次全國骨質(zhì)疏松和骨礦鹽疾病學(xué)術(shù)會議論文匯編[C];2013年

相關(guān)碩士學(xué)位論文 前3條

1 顏建湘;骨密度聯(lián)合椎體骨折評估在椎體脆性骨折中的應(yīng)用[D];福建醫(yī)科大學(xué);2015年

2 任曉靜;髖部結(jié)構(gòu)分析在預(yù)測髖部脆性骨折的意義[D];福建醫(yī)科大學(xué);2015年

3 王奔;藥物預(yù)防絕經(jīng)后骨質(zhì)疏松癥婦女脆性骨折的meta分析[D];天津醫(yī)科大學(xué);2013年

，

本文編號：1743781