摘要
目的 探讨老年人腰椎和髋部双能X线骨密度 (DEXA)测定T评分的一致性及髋部骨密度 (BMD)T评分在骨质疏松诊断中的意义。 方法 在排除患有影响骨量的疾病及使用影响骨代谢药物者后 ,选择 6 0～ 89岁老年人 2 6 0 (其中男 12 3人 ,女 137人 )例作为为研究对象。受检者均接受问卷调查、胸腰段脊椎正侧位X线摄片 ,DEXA测定 2～ 4腰椎 (L 2～ 4)椎体前后位和左髋部BMD(若左髋部发生过骨折或存有明显病变则改测右髋部 ) ,并进行有关统计分析。 结果 老年男性各年龄组L2～ 4BMDT评分比髋部要高 (P <0 0 1或P <0 0 5 ) ;老年女性除在 6 5～ 6 9岁、85～ 89岁年龄组腰椎BMDT评分比髋部要高 (P <0 0 1和P <0 0 5 )外 ,其余各组则差异无显著性。按照WHO标准 ,以髋部、腰椎和同时以髋部、腰椎BMDT评分为依据 ,在 12 3例男性中 ,分别有 19、6、5人被诊断为骨质疏松症 ;在 137例女性中 ,则分别有 35、17、14人被诊断为骨质疏松症 ;单以腰椎和同时以髋部、腰椎BMDT评分为依据所检出的骨质疏松症患者人数均少于单以髋部BMDT评分为依据者 (P<0 0 1)。 结论 在老年人尤其是老年男性 ,其腰椎BMDT评分明显高于髋部 ,髋部BMDT评分在骨质疏松诊断中的意义更为重要。
Objective To compare dual-energy X-ray absorptiometry T-score concordance between hip and lumbar spine, and to estimate the value of T-score of the hip for diagnosing osteoporosis in the elderly. Methods From September 2000 to May 2002, 123 males aged 60-89 years (average 72.0±7.4) and 137 females aged 60-88 years (average 67.3±6.1) were selected in the study based on the exclusion of subjects with apparent abnormalities affecting bone mass or taking medications which might affect bone metabolism. Detailed questionnaire included lifestyle factors such as smoking, drinking, exercise and dietary habits, etc. Radiographs of the thoracic and lumbar spine were taken. Patients' BMD were measured by DEXA (DMS, Challenger) at lumbar spine (L 2-4) and left hip in posterior-anterior projection. The right hip was scanned if patients had a history of fractures or any bone disease in the left hip. All data were statistically analysed using SPSS 8.0 system. Results The average T-scores of bone mineral density of the lumbar spine were higher than that of the hip in all male patients and in 65-, 85- age groups of female patients(P<0.01 and P<0.05). According to WHO criteria, there were 19,6,5 out of 123 male patients, and 35, 17,14 out of 137 female patients were diagnosed as primary osteoporosis based on T-scores of hip, lumbar, and both lumbar and hip, respectively. Single spine osteopososis and osteoporosis at both hip and spine were less happened than sinlge hip osteoporosis(P<0.01). Conclusions The average T-scores of bone mineral density at the lumbar spine are higher than that at the hip in the elderly, especially in the elderly men. The T-score of BMD at the hip plays an important role in the diagnosis of osteoporosis.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2003年第6期342-344,共3页
Chinese Journal of Geriatrics
