摘要
目的在保证诊断效率和可靠性的前提下,为临床骨质疏松症的初步诊断寻找一种优化的骨密度检测策略。方法共纳入1480名成人受试者,采用双能X线骨密度仪(DXA)分别在腰椎(L)1-4和左右髋部(LH和RH)进行骨密度测定。结果以L+LH+RH等3个部位骨密度T-值综合诊断骨质疏松为标准,所有2个部位联合和单部位中,L+LH骨密度诊断符合率最高(96.76%),L(76.93%)高于LH(66.53%)和RH(64.94%)。考虑到性别和年龄因素,在绝经后女性和50岁以上的男性中,大多数患者2个部位联合时,L+LH(91.84%~99.40%)骨密度的诊断符合率最高。绝经后女性和50~59岁的男性中,L的诊断符合率(63.27%~90.97%)高于其他单部位骨密度。结论L+LH是测量骨密度的第一选择,在有限的条件下,L也是有价值的。此外,对于不同部位骨密度检测诊断效率的热力图可能有助于骨质疏松症的个体化诊断。
Objective To find an optimized bone mineral density(BMD)detection strategy for clinical preliminary osteoporosis diagnosis on the premise of ensuring the diagnostic efficiency and reliability.Methods A total of 1480 adult subjects were recruited.The BMD of these participants was detected by dual-energy X-ray absorptiometry(DXA)in the lumbar spine orthotopic positions 1-4(L)and the left and right hip(LH and RH).Results The diagnostic efficiency of combined 3-sites(L+LH+RH)BMD was slightly higher than that of L+RH or L+LH BMD(P<0.05),and the likelihood of missed diagnosis was lower than 5%with combined 2-sites(L+LH and L+RH)BMD detection.If the diagnostic efficiency of combined 3-sites T-scores served as the standard,the diagnostic accordance rate of L+LH BMD was the highest(96.76%),and that of L(76.93%)was higher than that of LH(66.53%)and RH(64.94%)in all subjects.Considering the sex and age factors,the diagnostic accordance rate of L+LH(91.84%-99.40%)BMD was the highest in both 2-and 1-site BMD detections of most postmenopausal females and males over 50 years old.The diagnostic accordance rate of L(63.27%-90.97%)was higher than the only other 1-site BMD in most postmenopausal females and males 50-59 years old.Conclusion Our results suggest L+LH as the first option for BMD measurements,and L was also valuable under limited conditions.In addition,our thermograph of diagnostic efficiency in different BMD detection sites might be useful for the individual diagnosis of osteoporosis.
作者
周厚地
黎黎
刘瑶
刘欣鑫
陈泽琴
袁媛
钟二梅
隆敏
ZHOU Houdi;LI Li;LIU Yao;LIU Xinxin;CHEN Zeqin;YUAN Yuan;ZHONG Ermei;LONG Min(Department of Endocrinology, University Town Hospital of Chongqing Medical University, Chongqing 401331, China;Department of Endocrinology, Daping Hospital, Army Military Medical University, Chongqing 400042, China;Department of Endocrinology, Xinqiao Hospital, Army Military Medical University, Chongqing 400037, China;Applied Statistics, College of Mathematics and Statistics, Chongqing University, Chongqing 400044, China)
出处
《西部医学》
2022年第1期104-108,共5页
Medical Journal of West China
基金
国家自然科学基金面上项目(81873657)
第三军医大学(陆军军医大学)苗圃培育项目(2017R019)
第三军医大学新桥医院临床研究项目(2016YLC15-M.L.)。
关键词
骨质疏松
骨密度
双能X线
检测部位
诊断效果
Osteoporosis
Bone density
Dual-energy X-ray absorptiometry
Detection site
Diagnosis efficiency
