CAJ | 학술논문

背景:针对双能X线前后位腰椎骨密度测定受腰椎骨质增生或压缩性骨折等因素的影响,易造成骨密度结果判断的误差,导致临床对骨质疏松症的漏诊、误诊.目的:通过对腰椎前后位骨密度、骨矿含量及面积相互关系的探讨,寻找正确评价骨密度可靠的相关依据.设计:前瞻性队列研究. 地点和对象:实验由解放军总医院老年医学研究所完成.在北京市区选择20岁以上1 567例健康人作为研究对象,其中男591例;女976例,职业包括军队和地方干部、教师、工人、居民.特殊职业者及患有各种影响骨代谢的急、慢性疾病者均除外.干预:按10岁为1个年龄段,将其分为8组.应用双能X线骨密度仪(DXA)进行腰椎骨密度、骨矿含量、面积的测定,确定不同性别平衡峰值期骨密度的年龄段、计算其骨矿含量及面积均值,以身高为自变量,骨密度为应变量分别作直线回归,建立骨矿含量、面积与身高的回归方程,利用其回归方程进行骨密度正常值的预报.主要观察指标:腰椎前后位骨密度、骨矿含量和面积.结果:平衡峰值骨密度的年龄,男性为20～49岁,女性为30～49岁;骨矿含量及面积的均值,男性分别为56.47 g及46 39 cm2,女性分别为47.418%及41.12 cm2.90%正常范围:男性骨矿含量=0.327×身高(cm)±14.76,面积=0 271×身高(cm)±5.96,女性骨矿含量0.294×身高(cm)±11.85,面积=0.225×身高(cm)±5.00.结论:仅靠腰椎骨密度结果评价骨质疏松的可靠性不准确,正确评价腰椎的骨矿含量与面积,对骨密度测量的可靠程度可做出较准确判断.
배경:침대쌍능X선전후위요추골밀도측정수요추골질증생혹압축성골절등인소적영향,역조성골밀도결과판단적오차,도치림상대골질소송증적루진、오진.목적:통과대요추전후위골밀도、골광함량급면적상호관계적탐토,심조정학평개골밀도가고적상관의거.설계:전첨성대렬연구. 지점화대상:실험유해방군총의원노년의학연구소완성.재북경시구선택20세이상1 567례건강인작위연구대상,기중남591례;녀976례,직업포괄군대화지방간부、교사、공인、거민.특수직업자급환유각충영향골대사적급、만성질병자균제외.간예:안10세위1개년령단,장기분위8조.응용쌍능X선골밀도의(DXA)진행요추골밀도、골광함량、면적적측정,학정불동성별평형봉치기골밀도적년령단、계산기골광함량급면적균치,이신고위자변량,골밀도위응변량분별작직선회귀,건립골광함량、면적여신고적회귀방정,이용기회귀방정진행골밀도정상치적예보.주요관찰지표:요추전후위골밀도、골광함량화면적.결과:평형봉치골밀도적년령,남성위20～49세,녀성위30～49세;골광함량급면적적균치,남성분별위56.47 g급46 39 cm2,녀성분별위47.418%급41.12 cm2.90%정상범위:남성골광함량=0.327×신고(cm)±14.76,면적=0 271×신고(cm)±5.96,녀성골광함량0.294×신고(cm)±11.85,면적=0.225×신고(cm)±5.00.결론:부고요추골밀도결과평개골질소송적가고성불준학,정학평개요추적골광함량여면적,대골밀도측량적가고정도가주출교준학판단.
BACKGROUND: As the test of dual energy X-ray absorptiomety (DXA) of lumbar bone mineral density(BMD) in anteroposterior position could be influenced by lumbar hyperosteogeny, compression fracture, etc., the error in the judgment of the result of BMD, could lead to missed diagnosis and misdiagnosis of osteoporosis.OBJECTIVE: To explore the reliable related evidence of correct evaluation through the study of the mutual relationship of BMD with bone mineral content (BMC) and area.DESIGN: A prospective cohort study was conducted.SETTING and PARTICIPANTS: The experiment was completed in the Institute of Geriatrics and Gerontology, General Hospital of Chinese PLA. Totally 1567 cases of healthy persons over 20 years old in Beijing were selected as subjects. There were 591 males and 976 females. Their vocations include army or civil cadre, teacher, worker and urban resident. Persons with special vocations and with various acute and chronic disorders influencing the bone metabolism were excluded.INTERVENTIONS: Patients were divided into 8 groups with 10 years as the age difference between them. The BMD, mineral contents and area of lumbar vertebrae were tested with DXA to define the aging variation in the mineral density during equilibrium peak period of different gender groups. Mean mineral contents and area were calculated. Regression equation of mineral content, area and height was established with body height as the independent variance and BMD as the dependent variance to forecast the normal value of BMD.MAIN OUTCOME MEASURES: BMD of lumbar bone BMC and area in anteroposterior position.RESULTS: The age groups at equilibrium peak value stage were 20- 49years in men and 30 -49 years in women respectively. The mean BMC and area were 56.47 g and 46. 39 cm2 in men and 47. 418 g and 41. 12 cm2 in women respectively. For the 90 percent of normal range, BMC in males equals 0. 327 x height(cm) ±: 14.76, area equals 0. 271 x height(cm) ±5.96, and BMC in females equals 0. 294 x height(cm) ± 11.85, and areaequals 0. 225 × height (cm) ± 5.00.