提出绝经后女性骨小梁的体密度(volume bone mineral density,vBMD)、力学特性与组织形态计量参数在体分析方法,揭示其在不同解剖学区域的特异性分布规律,骨小梁组织结构与力学特点的局部相关关系。运用高分辨率外周定量断层扫描(high r...提出绝经后女性骨小梁的体密度(volume bone mineral density,vBMD)、力学特性与组织形态计量参数在体分析方法,揭示其在不同解剖学区域的特异性分布规律,骨小梁组织结构与力学特点的局部相关关系。运用高分辨率外周定量断层扫描(high resolution peripheral quantitative computed tomographic,HR-pQCT),首次建立了骨密度区域映射方法和骨小梁与骨髓多材料有限元模型,在体分析了10名绝经后女性骨小梁在胫骨前、后、外、内侧4个解剖区域的骨密度分布与力学特点区域间特异性。运用统计学方法分析组织形态参数与刚度局部区域间的相关性。研究发现骨小梁力学特性、结构与密度在不同解剖学部位的差异具有显著性差异,最低(前侧)骨小梁的强度为最高(内侧)区域的29.11%(P<0.05)。并且发现胫骨前侧和后侧、内侧和外侧都表现出了显著的两两相关的关系。骨小梁与骨髓多材料有限元模型方法为在体分析骨小梁力学与材料特性提供了可能方法。骨组织结构存在区域间相关关系,对了解胫骨材料特点,预测胫骨骨折部位具有指导性意义。展开更多
国际临床骨密度学会（ISCD）在2007年根据Engelke等十一位国际著名专家组意见，形成了QCT和外周定量CT（pQCT）骨密度测量在骨质疏松诊疗的临床应用共识，全文发表在Journal of Clinical Densitometry，2008，11：123—162上。鉴于pQCT...国际临床骨密度学会（ISCD）在2007年根据Engelke等十一位国际著名专家组意见，形成了QCT和外周定量CT（pQCT）骨密度测量在骨质疏松诊疗的临床应用共识，全文发表在Journal of Clinical Densitometry，2008，11：123—162上。鉴于pQCT在国内尚未开展，省略该共识中关于pQCT的相关内容。本文作者通过仔细阅读和翻译该共识文章，摘录如下。展开更多
Background The association of long-term bisphosphonate treatment for osteoporosis and related safety problems such as atypical fractures were not clearly defined. This study was to evaluate the structural, densitometr...Background The association of long-term bisphosphonate treatment for osteoporosis and related safety problems such as atypical fractures were not clearly defined. This study was to evaluate the structural, densitometric and biomechanical properties of the prolonged bisphosphonate-loaded bones. Methods Bone mineral density （BMD） at hip and femoral midshaft, bone cross-sectional area, moment of inertia of both femurs, bone formation and resorption biochemical markers were compared between 28 elderly with at least 4 years of bisphosphonate treatment from 2002 through 2006 and age-matched group of 37 elderly. Results The total hip BMD and t-score were found not different between two groups. However, bisphosphonate treated patients were found to have significantly lower bone mineral content in the femoral shaft （P 〈0.05）; morphological study showed lower cross-sectional area in subtrochanteric and mid-diaphyseal region and thus significantly lower moment of inertia （P 〈0.01）. High resolution-peripheral quantitative computed tomography showed significantly decreased trabeculardensity, bone volume ratio, trabecular number but increased trabecular spacing in tibia and distal radius. Finite element analysis further confirmed significantly lower stiffness and failure load in tibia. Biochemical studies also showed lower bone resorption and severely suppressed bone formation activity （P 〈0.001）. Conclusions The unchanged total hip BMD between two groups confirmed the beneficial effects of bisphosphonate on trabecular bone, thus preventing osteoporotic fractures at large in previous studies. However, the inferior structural, densitometric and biomechanical properties at cortical bones, especially femur midshaft, need a special attention to look into the association between long-term bisphosphonate intake and the occurrence of stress fractures. When patients taking bisphosphonate complain of proximal thigh pain or discomfort, plain X-ray film can be the first line screening. All patients prescribed with bisphosphonate should be informed of such a complication though we must stress its rarity.展开更多
文摘提出绝经后女性骨小梁的体密度(volume bone mineral density,vBMD)、力学特性与组织形态计量参数在体分析方法,揭示其在不同解剖学区域的特异性分布规律,骨小梁组织结构与力学特点的局部相关关系。运用高分辨率外周定量断层扫描(high resolution peripheral quantitative computed tomographic,HR-pQCT),首次建立了骨密度区域映射方法和骨小梁与骨髓多材料有限元模型,在体分析了10名绝经后女性骨小梁在胫骨前、后、外、内侧4个解剖区域的骨密度分布与力学特点区域间特异性。运用统计学方法分析组织形态参数与刚度局部区域间的相关性。研究发现骨小梁力学特性、结构与密度在不同解剖学部位的差异具有显著性差异,最低(前侧)骨小梁的强度为最高(内侧)区域的29.11%(P<0.05)。并且发现胫骨前侧和后侧、内侧和外侧都表现出了显著的两两相关的关系。骨小梁与骨髓多材料有限元模型方法为在体分析骨小梁力学与材料特性提供了可能方法。骨组织结构存在区域间相关关系,对了解胫骨材料特点,预测胫骨骨折部位具有指导性意义。
文摘国际临床骨密度学会（ISCD）在2007年根据Engelke等十一位国际著名专家组意见，形成了QCT和外周定量CT（pQCT）骨密度测量在骨质疏松诊疗的临床应用共识，全文发表在Journal of Clinical Densitometry，2008，11：123—162上。鉴于pQCT在国内尚未开展，省略该共识中关于pQCT的相关内容。本文作者通过仔细阅读和翻译该共识文章，摘录如下。
文摘Background The association of long-term bisphosphonate treatment for osteoporosis and related safety problems such as atypical fractures were not clearly defined. This study was to evaluate the structural, densitometric and biomechanical properties of the prolonged bisphosphonate-loaded bones. Methods Bone mineral density （BMD） at hip and femoral midshaft, bone cross-sectional area, moment of inertia of both femurs, bone formation and resorption biochemical markers were compared between 28 elderly with at least 4 years of bisphosphonate treatment from 2002 through 2006 and age-matched group of 37 elderly. Results The total hip BMD and t-score were found not different between two groups. However, bisphosphonate treated patients were found to have significantly lower bone mineral content in the femoral shaft （P 〈0.05）; morphological study showed lower cross-sectional area in subtrochanteric and mid-diaphyseal region and thus significantly lower moment of inertia （P 〈0.01）. High resolution-peripheral quantitative computed tomography showed significantly decreased trabeculardensity, bone volume ratio, trabecular number but increased trabecular spacing in tibia and distal radius. Finite element analysis further confirmed significantly lower stiffness and failure load in tibia. Biochemical studies also showed lower bone resorption and severely suppressed bone formation activity （P 〈0.001）. Conclusions The unchanged total hip BMD between two groups confirmed the beneficial effects of bisphosphonate on trabecular bone, thus preventing osteoporotic fractures at large in previous studies. However, the inferior structural, densitometric and biomechanical properties at cortical bones, especially femur midshaft, need a special attention to look into the association between long-term bisphosphonate intake and the occurrence of stress fractures. When patients taking bisphosphonate complain of proximal thigh pain or discomfort, plain X-ray film can be the first line screening. All patients prescribed with bisphosphonate should be informed of such a complication though we must stress its rarity.
