CAJ | 학술논문

背景:双能X线、CT有射线、验血有创伤和感染的概率,不适合骨质疏松症的普查和跟踪随访.而超声骨密度仪具有无放射性、无创伤性、重复性好的优点,它根据受检者的年龄、性别和体质量等许多项参数得出的结果,数据相对可靠.目的:了解老年知识分子的骨质疏松症的情况,为今后此病的预防、诊断和治疗提供有效依据.设计:以诊断为依据的病例对照研究.地点、对象和方法:对上海市南市区离退休教师作跟骨骨密度检查.男150例,体质量(67±10)kg;女663例,体质量(59±9)kg.调查退休教师的年龄、性别、体质量、身高和多种疾病(糖尿病、结核、高血压、骨质增生和骨折等)与超声振幅衰减值(broadband ultrasound attenuation,BUA)之间的关系.主要观察指标:男女骨质疏松症患者跟骨BUA值.结果:男性、女性组平均BUA值分别为63.9,58.9 dB/MHz,声速分别为1485.2,1504.1 m/s.体质量与BUA、声速呈显著正相关(R=0.0466,0.177 3.P＜0.05).男女性喝牛奶与不喝牛奶组BUA值比较,差异有显著性意义(x2=4.012 4,5.949 5,P＜0.05).男性得与未得肺结核患者BUA值差异有显著性意义(x2=6.388 2,P＜0.05).体质量大于或等于65 kg者BUA值小于正常参考值的人数明显减少,在60岁以上随着年龄增长与骨量的丢失之间没有显著关系.结论:受检者的年龄、性别、体质量和某些疾病与BUA值有关,男性BUA值比女性高;随着年龄的增加骨量减少很小或不减少,当超声振幅衰减值突然降低时可以预测会发生骨质疏松症.
배경:쌍능X선、CT유사선、험혈유창상화감염적개솔,불괄합골질소송증적보사화근종수방.이초성골밀도의구유무방사성、무창상성、중복성호적우점,타근거수검자적년령、성별화체질량등허다항삼수득출적결과,수거상대가고.목적:료해노년지식분자적골질소송증적정황,위금후차병적예방、진단화치료제공유효의거.설계:이진단위의거적병례대조연구.지점、대상화방법:대상해시남시구리퇴휴교사작근골골밀도검사.남150례,체질량(67±10)kg;녀663례,체질량(59±9)kg.조사퇴휴교사적년령、성별、체질량、신고화다충질병(당뇨병、결핵、고혈압、골질증생화골절등)여초성진폭쇠감치(broadband ultrasound attenuation,BUA)지간적관계.주요관찰지표:남녀골질소송증환자근골BUA치.결과:남성、녀성조평균BUA치분별위63.9,58.9 dB/MHz,성속분별위1485.2,1504.1 m/s.체질량여BUA、성속정현저정상관(R=0.0466,0.177 3.P＜0.05).남녀성갈우내여불갈우내조BUA치비교,차이유현저성의의(x2=4.012 4,5.949 5,P＜0.05).남성득여미득폐결핵환자BUA치차이유현저성의의(x2=6.388 2,P＜0.05).체질량대우혹등우65 kg자BUA치소우정상삼고치적인수명현감소,재60세이상수착년령증장여골량적주실지간몰유현저관계.결론:수검자적년령、성별、체질량화모사질병여BUA치유관,남성BUA치비녀성고;수착년령적증가골량감소흔소혹불감소,당초성진폭쇠감치돌연강저시가이예측회발생골질소송증.
BACKGROUND: Dual-energy X-ray and computed tomography(CT) are not the best choices for mass screening and follow-up survey of osteoporosis for their radiation exposure of the examinees, nor is blood test for such purposes due to the traumas it causes that exposes the subjects to potential risk of infections. As a non-radioactive, non-traumatic modality with reproducible results, ultrasound bone measurement may yield more reliable data in relation to the examinee's age, sex, mass and so on, for the identification of osteoporosis.OBJECTIVE: To understand the situation of osteoporosis among retired teachers for its prevention, diagnoses and treatment.DESIGN: Diagnosis-based case-controlled trial.SETTING, PARTICIPANTS and METHODS: A total of 813 retiredteachers from Nanshi District of Shanghai, China, including 150 male subjects(67 ± 10) kg and 663 female subjects(59 ±9) kg, were examined by ultrasound bone density measurement. The relationship between broadband ultrasound attenuation(BUA) and the subject's age, sex, mass, height and various diseases such as diabetes mellitus, tuberculosis, hypertension, hyperostosis, osteosclerosis, and fractures were investigated.MAIN OUTCOME MEASURES: The calcaneal BUA value of the subjects was measured.RESULTS: The average BUA value of the male and female subjects was 63.9 and 58.9 dB/MHz, and the speed of sound(SOS) was 1 485.2 and 1 504.1 m/s, respectively. Multiple regression analysis showed that the subject's mass was positively correlated with BUA value and SOS( r=0. 0466, 0. 1773; P ＜ 0.05). The BUA value differed significantly between subjects regularly drinking milk and those who did not, which was true for both male and female subjects(x2 =4. 0124, 5. 9495, P ＜ 0. 05) . In male subjects, pulmonary tuberculosis made a significant difference in the BUA value (x2 =6. 3882, P ＜ 0.05). Statistical analysis indicated that subjects weighing no less than 65 kg were more unlikely to have a BUA value lower than the normal value, and no obvious association was noted between bone mass loss and the increase of the subject's age, when they were over 60 years old.CONCLUSION: Age, sex, mass and some diseases are related to the BUA value, which is higher in man than in woman. Bone mass loss is hardly related to increased age in subject over 60 years old, and sudden reduction in the BUA value can be indicative of the occurrence of osteoporosis.