中国临床康复
中國臨床康複
중국림상강복
CHINESE JOURNAL OF CLINICAL REHABILITATION
2005年
3期
242-244
,共3页
骨质疏松症%骨密度%评价研究
骨質疏鬆癥%骨密度%評價研究
골질소송증%골밀도%평개연구
背景:早期诊治骨质疏松( osteoporosis, OP)目前仍以骨密度( bone mineral density, BMD)的测定为标准.但在测定中随不同性别、不同年龄、骨骼不同部位的 OP检出率不同,有必要分析这种差别. 目的:比较不同性别随增龄在骨骼不同部位骨质疏松检出率的不同. 设计:以患者为研究对象的横断面调查. 单位:一所军队炮兵总医院的内分泌科. 对象:本研究在解放军第二炮兵总医院内分泌科完成.选择 2000- 09/2002- 01在本院门诊就诊的患者共 147例,其中男 54例,女 93例,年龄 50～ 78岁.按年龄分为 3组,即 50～ 59岁组、 60～ 69岁组和 70～ 79岁组,各组人数分别为 46例(男 13例,女 33例), 66例(男 26例,女 40例)和 35例(男 15例,女 20例).纳入标准:①年龄≥ 50岁,女性均为绝经后;②符合 WHO推荐的 OP诊断标准 [1].排除标准:患肝、肾、心脏、胃肠道等脏器慢性疾病及糖尿病、甲亢等内分泌疾病引起的继发性骨质疏松者. 方法:每个受试者详细填写病史调查表,准确测量身高和体质量,并计算体质量指数( kg/m2).应用本院新型 Norland Excell plus 双能 X线骨密度吸收仪( DEXA)测定每一受试者的 L2- 4及股骨近端(股骨颈、 Ward' s三角、大转子) BMD值( g/cm2).将所测值与同性别年轻成年人正常数据比较,得出 T评分(即 SD). 主要观察指标:①不同性别、年龄、部位 OP检出结果比较;②年龄及体质量指数与 BMD的相关性. 结果:女性更年期以腰椎 OP为主(χ 2=10.14,P< 0.01),随年龄增加腰椎和股骨颈均出现 OP的检出率增加 (χ 2=7.41,P< 0.05);男性 60岁以后以单纯股骨颈 OP增加明显(χ 2=9.11,P< 0.05);女性较男性更易患单纯腰椎 OP及腰椎和股骨颈均出现 OP(χ 2=8.04,P< 0.05;χ 2=14.26,P< 0.01);女性年龄与股骨颈、 Ward, s三角及大转子区 BMD有明显负相关( r=- 0.364,- 0.389,P< 0.01;r=- 0.504,P< 0.001);体质量指数与 L2～ 4、股骨颈和大转子 BMD有明显正相关( r=0.306,0.329,0.338,P< 0.05). 结论 : OP的检出率随骨骼测量部位和年龄的变化而变化.正确认识和评价这些客观现象,对 OP的诊治具有重要意义.
揹景:早期診治骨質疏鬆( osteoporosis, OP)目前仍以骨密度( bone mineral density, BMD)的測定為標準.但在測定中隨不同性彆、不同年齡、骨骼不同部位的 OP檢齣率不同,有必要分析這種差彆. 目的:比較不同性彆隨增齡在骨骼不同部位骨質疏鬆檢齣率的不同. 設計:以患者為研究對象的橫斷麵調查. 單位:一所軍隊砲兵總醫院的內分泌科. 對象:本研究在解放軍第二砲兵總醫院內分泌科完成.選擇 2000- 09/2002- 01在本院門診就診的患者共 147例,其中男 54例,女 93例,年齡 50～ 78歲.按年齡分為 3組,即 50～ 59歲組、 60～ 69歲組和 70～ 79歲組,各組人數分彆為 46例(男 13例,女 33例), 66例(男 26例,女 40例)和 35例(男 15例,女 20例).納入標準:①年齡≥ 50歲,女性均為絕經後;②符閤 WHO推薦的 OP診斷標準 [1].排除標準:患肝、腎、心髒、胃腸道等髒器慢性疾病及糖尿病、甲亢等內分泌疾病引起的繼髮性骨質疏鬆者. 方法:每箇受試者詳細填寫病史調查錶,準確測量身高和體質量,併計算體質量指數( kg/m2).應用本院新型 Norland Excell plus 雙能 X線骨密度吸收儀( DEXA)測定每一受試者的 L2- 4及股骨近耑(股骨頸、 Ward' s三角、大轉子) BMD值( g/cm2).將所測值與同性彆年輕成年人正常數據比較,得齣 T評分(即 SD). 主要觀察指標:①不同性彆、年齡、部位 OP檢齣結果比較;②年齡及體質量指數與 BMD的相關性. 結果:女性更年期以腰椎 OP為主(χ 2=10.14,P< 0.01),隨年齡增加腰椎和股骨頸均齣現 OP的檢齣率增加 (χ 2=7.41,P< 0.05);男性 60歲以後以單純股骨頸 OP增加明顯(χ 2=9.11,P< 0.05);女性較男性更易患單純腰椎 OP及腰椎和股骨頸均齣現 OP(χ 2=8.04,P< 0.05;χ 2=14.26,P< 0.01);女性年齡與股骨頸、 Ward, s三角及大轉子區 BMD有明顯負相關( r=- 0.364,- 0.389,P< 0.01;r=- 0.504,P< 0.001);體質量指數與 L2～ 4、股骨頸和大轉子 BMD有明顯正相關( r=0.306,0.329,0.338,P< 0.05). 結論 : OP的檢齣率隨骨骼測量部位和年齡的變化而變化.正確認識和評價這些客觀現象,對 OP的診治具有重要意義.
배경:조기진치골질소송( osteoporosis, OP)목전잉이골밀도( bone mineral density, BMD)적측정위표준.단재측정중수불동성별、불동년령、골격불동부위적 OP검출솔불동,유필요분석저충차별. 목적:비교불동성별수증령재골격불동부위골질소송검출솔적불동. 설계:이환자위연구대상적횡단면조사. 단위:일소군대포병총의원적내분비과. 대상:본연구재해방군제이포병총의원내분비과완성.선택 2000- 09/2002- 01재본원문진취진적환자공 147례,기중남 54례,녀 93례,년령 50～ 78세.안년령분위 3조,즉 50～ 59세조、 60～ 69세조화 70～ 79세조,각조인수분별위 46례(남 13례,녀 33례), 66례(남 26례,녀 40례)화 35례(남 15례,녀 20례).납입표준:①년령≥ 50세,녀성균위절경후;②부합 WHO추천적 OP진단표준 [1].배제표준:환간、신、심장、위장도등장기만성질병급당뇨병、갑항등내분비질병인기적계발성골질소송자. 방법:매개수시자상세전사병사조사표,준학측량신고화체질량,병계산체질량지수( kg/m2).응용본원신형 Norland Excell plus 쌍능 X선골밀도흡수의( DEXA)측정매일수시자적 L2- 4급고골근단(고골경、 Ward' s삼각、대전자) BMD치( g/cm2).장소측치여동성별년경성년인정상수거비교,득출 T평분(즉 SD). 주요관찰지표:①불동성별、년령、부위 OP검출결과비교;②년령급체질량지수여 BMD적상관성. 결과:녀성경년기이요추 OP위주(χ 2=10.14,P< 0.01),수년령증가요추화고골경균출현 OP적검출솔증가 (χ 2=7.41,P< 0.05);남성 60세이후이단순고골경 OP증가명현(χ 2=9.11,P< 0.05);녀성교남성경역환단순요추 OP급요추화고골경균출현 OP(χ 2=8.04,P< 0.05;χ 2=14.26,P< 0.01);녀성년령여고골경、 Ward, s삼각급대전자구 BMD유명현부상관( r=- 0.364,- 0.389,P< 0.01;r=- 0.504,P< 0.001);체질량지수여 L2～ 4、고골경화대전자 BMD유명현정상관( r=0.306,0.329,0.338,P< 0.05). 결론 : OP적검출솔수골격측량부위화년령적변화이변화.정학인식화평개저사객관현상,대 OP적진치구유중요의의.
BACKGROUND:Bone mineral density(BMD) is still regarded as the standard of early diagnosis and treatment of osteoporosis(OP) at present.But it is found in detection that different sex,age and skeleton location have different OP detection rate,so it is necessary to analyze the difference. OBJECTIVE:To compare the difference of OP detection rate at different skeleton location between males and females with the increase of age. DESIGN:A cross-sectional study taking patients as the subjects. SETTING:Endocrine department of an artillery general hospital of Chinese PLA. PARTICIPANTS:A total of 147 patients,including 54 males and 93 females, aged from 50 to 78 years old,who were hospitalized in our outpatient clinic from September 2000 to January 2002,were selected and divided into 3 groups according to age,50 to 59 years old group (n=46,13 males and 33 females),60 to 69 years old group (n=66,26 males and 40 females) and 70 to 79 years old group (n=35,15 accordance with the OP diagnostic criteria recommended by WHO[1]. Exclusive criterion: secondary OP patients caused by chronic disease of liver,kidney, heart, and gastrointestinal tract and some endocrine disease such as diabetes,hyperthyroidism and so on. INTERVENTIONS:Every subject filled in the history questionnaire in detail.Height and body mass were measured accurately and body mass index(BMI) was calculated (kg/m2).A new type of Norland Excell plus dual-energy X-ray absorptiometry(DEXA) was used to detect BMD(g/cm2) of L2- 4 and proximate femur(neck of femur, Ward's triangle,greater trochanter).The detected values were compared with the normal data of young adults of the same sex and the T value(SD) was obtained. RESULTS:OP in lumber vertebra was predominant in female climacteric(χ 2=10.14,P< 0.01),and the detection rate of OP in lumber vertebra and neck of femur increased with age(χ 2=7.41, P< 0.05).OP in simple neck of femur increased significantly in males after 60 yeas old(χ 2=9.11,P< 0.05). Females were more liable to suffer from OP in simple lumber vertebra and in both lumber vertebra and neck of femur(χ 2=8.04,P< 0.05;χ 2=14.26,P< 0.01).Age had significant negative correlation with BMD in neck of femur,Ward's triangle and great trochanter of females(r=- 0.364,- 0.389, P< 0.01;r=- 0.504,P< 0.001),while BMI was positively correlated with L2- 4,neck of femur and great trochanter significantly(r=0.306,0.329,0.338,P< 0.05). CONCLUSION:Detection rate of OP changes with skeleton detecting location and age.It is very significant to recognize and evaluate these objective phenomena correctly for the diagnosis and treatment of OP.
